Madden Megan, Collins Richard, Schwarz Tobias, Suñol Anna
J Vet Med Educ. 2022 Jul 4:e20210159. doi: 10.3138/jvme-2021-0159.
Cerebrospinal fluid (CSF) sampling at the lumbar subarachnoid space (LSS) is technically challenging to learn. Currently, training relies on cadaver availability or performance in a clinical scenario. This study aims to develop and validate a low-cost, high-fidelity simulator to train in this technique. Using three-dimensional printing technology, a model of a healthy adult dog's lumbosacral vertebral column was produced. The model was augmented with synthetic materials and a fluidic system to replicate all procedural steps and permit successful CSF collection. The simulator was validated by four experts, who rated it highly across multiple criteria. Final-year veterinary students were recruited to take part in practical sessions using either the simulator ( = 16) or a cadaver ( = 16). Performance was recorded for each student, and feedback was obtained using an anonymous online survey. Student performance was similar between groups ( = .2), with 87.5% and 68.75% of students in the simulator and cadaver group, respectively, successfully placing the needle into the LSS. All successful students in the simulator group were able to obtain a CSF sample, versus none in the cadaver group. No difference in the number of attempts was detected between groups ( > .99), with most students taking more than three attempts. User experience was similar between groups, with 93.8% of students in each group rating the session as a positive learning experience. In summary, we demonstrate the validity of a novel, low-cost, and anatomically precise simulator that can be used for teaching CSF sampling at the LSS.
在腰蛛网膜下腔(LSS)采集脑脊液(CSF)在技术学习上具有挑战性。目前,培训依赖于尸体可用性或临床场景中的操作。本研究旨在开发并验证一种低成本、高保真的模拟器来培训这项技术。利用三维打印技术,制作了一个健康成年犬腰骶部脊柱模型。该模型用合成材料和流体系统进行了增强,以复制所有操作步骤并允许成功采集脑脊液。该模拟器由四位专家进行验证,他们在多个标准上对其给予了高度评价。招募了兽医专业最后一年的学生参加实践课程,他们分别使用模拟器(n = 16)或尸体(n = 16)。记录了每位学生的操作表现,并通过匿名在线调查获得反馈。两组学生的表现相似(P = 0.2),模拟器组和尸体组分别有87.5%和68.75%的学生成功将针插入腰蛛网膜下腔。模拟器组所有成功的学生都能够采集到脑脊液样本,而尸体组则无人成功。两组之间在尝试次数上未检测到差异(P > 0.99),大多数学生尝试了三次以上。两组的用户体验相似,每组93.8%的学生将课程评价为积极的学习体验。总之,我们证明了一种新型、低成本且解剖学精确的模拟器可用于腰蛛网膜下腔脑脊液采样教学的有效性。