Song Jaeeun, Ock Junhyeok, Kim Wook-Jong, Park Yong-Seok, Kim Namkug, Kim Sung-Hoon
Department of Anesthesiology and Pain Medicine, Asan Medical Centre, University of Ulsan College of Medicine, BK21 Project, Seoul, South Korea.
Department of Convergence Medicine, Asan Medical Centre, Asan Medical Institute of Convergence Science and Technology, University of Ulsan College of Medicine, Seoul, Republic of Korea.
J Med Syst. 2025 Jun 3;49(1):75. doi: 10.1007/s10916-025-02209-9.
This study aimed to enhance cricothyroidotomy training for novice practitioners using three-dimensional-printed patient-specific models based on computed tomography images of a patient with obesity, evaluate these models compared to conventional training phantoms, and suggest possible effective training methods. A prospective, randomised crossover study was conducted with 30 medical students with no prior cricothyroidotomy experience. Participants performed the procedure on a conventional and a patient-specific model. Performance was assessed using time, visual inspections, and a three-dimensional scanner to evaluate the accuracy of the cricothyroidotomy simulation. The correlation between total time and checklist times for procedural step skills was analysed. Furthermore, a post-study survey was conducted to evaluate participants' perceptions of the realism and utility of both simulators. Patient-specific simulators required a longer time (18.63 ± 6.96 s) to confirm tracheal position compared to conventional simulators (15.28 ± 6.96 s; p = 0.034). Conversely, conventional simulators required a longer time (44.86 ± 27.56 s) to intubate than patient-specific simulators (27.96 ± 9.73 s; p < 0.001). Patient-specific simulators exhibited a greater deviation from the intended puncture site (17.14 ± 8.03 mm) compared to conventional simulators (2.95 ± 1.25 mm; p < 0.001), despite high visual success rates for both models. Survey results showed significantly higher ratings for the patient-specific simulator in terms of fidelity, utility, and special features (p < 0.001). This study assessed both time and accuracy in evaluating and enhancing training and procedural outcomes, being the first to incorporate a three-dimensional scanner into assessing outcomes. The findings, along with positive participant feedback from the post-study survey, emphasise the need for specialised training programmes incorporating a three-dimensional-printed, patient-specific models that reflect challenging scenarios particularly involving patients with obesity.
本研究旨在利用基于肥胖患者计算机断层扫描图像的三维打印个体化模型，加强对新手从业者的环甲膜切开术培训，将这些模型与传统训练模型进行比较，并提出可能有效的训练方法。对30名此前无环甲膜切开术经验的医学生进行了一项前瞻性随机交叉研究。参与者在传统模型和个体化模型上进行该操作。使用时间、视觉检查和三维扫描仪评估操作表现，以评估环甲膜切开术模拟的准确性。分析了总时间与程序步骤技能核对表时间之间的相关性。此外，在研究结束后进行了一项调查，以评估参与者对两种模拟器的真实感和实用性的看法。与传统模拟器（15.28±6.96秒；p=0.034）相比，个体化模拟器确认气管位置所需时间更长（18.63±6.96秒）。相反，传统模拟器插管所需时间（44.86±27.56秒）比个体化模拟器（27.96±9.73秒；p<0.001）更长。尽管两种模型的视觉成功率都很高，但与传统模拟器（2.95±1.25毫米；p<0.001）相比，个体化模拟器与预期穿刺部位的偏差更大（17.14±8.03毫米）。调查结果显示，个体化模拟器在逼真度、实用性和特殊功能方面的评分显著更高（p<0.001）。本研究在评估和加强培训及操作结果时兼顾了时间和准确性，是首个将三维扫描仪纳入结果评估的研究。这些发现，以及研究结束后调查中参与者的积极反馈，强调了需要开展专门的培训项目，纳入三维打印的个体化模型，以反映具有挑战性的场景，尤其是涉及肥胖患者的场景。
