Lindsay Myer
Designer - Engineer - Entrepreneur
Bronchoscopy Trainer
On a visit to The Winter Institute for Simulation, Education, and Research (WISER), I learned how medical students train to perform bronchoscopy procedures. Although, there are mannequins to simulate a patient, WISER created a tool that is able to help students practice the basics of the procedure. However, it didn't simulate the procedure well enough for students to master the proper technique and perform the procedure under 45 seconds. These skills are vital to medical students.
Therefore, I was motivated to create a new device that helps students build their skills needed to perform the procedure using the scope.
Understanding the Current Trainer
In addition to interviewing WISER staff, I got the opportunity to observe how they teach medical students to use the scopes. After interviewing and observing the participants, I made the following insights:
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Variability
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Students can only practice off one tube and clock target. This makes it hard to practice all of the proper hand movements.
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Simulation
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During a real procedure, medical students need to make sure they go through the trachea and not the esophagus. Then once they hit the bifurcation of the lungs, they need to move the scope a bit further without going into either lung.
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Students do not have the ability to see the inside of the body during the actual procedure. Instead, a video feed is on a screen. The current trainer lets users see the entire process.
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Transitions
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Students are unable to practice certain skills and build off of them. It can be hard to transition from the basic trainer to a more complicated mannequin and then an actual person.
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Rapid Prototyping
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Prototype 1
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Initial sketches were used to conceptualize basic parts of the trainer. This iteration included several snap in parts to offer variability. However, these pieces did not model the actual procedure and were not user friendly.
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Prototype 2
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This design utilized flaps to put attachments into place. These attachments simulated the trachea and bifurcation. To hold the components, storage was added inside the base. In addition, a cover was designed to flip over the side of the trainer at the user's choosing.
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Prototype 3
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The final prototype was made out of cardboard to determine proper dimensioning of a human body. There is on average 22 cm between the mouth piece and the beginning of the bifurcation. Then the scope travels 4 cm. This dimensioning was used for the final design.
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Fabrication Techniques
Final Design
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Simulates the Procedure
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Different components can snap into place for easy, intermediate and advanced skillsets
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Beginner: there is one long tube to learn how to use the scope
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Intermediate: a component snaps in to practice going into the trachea and bifurcation
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Advanced: a short tube snaps in to simulate obstructions to practice cases with tumors
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Students can cover the trainer to practice without looking
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User Friendly
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The attachments easily snap in and can fit in any order
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The attachments fit into the drawer inside of the tube
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Adaptability
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Users have the ability to change the targets from a clock to colored dots and a maze
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Students and Doctors can easily build more attachments and targets to simulate additional procedures
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Engaging
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A timer (stored in the drawer) can be attached to the outside of the trainer to test students
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Students can continuously build their skills and bring the trainer anywhere, such as the hospital, at home or in a classroom
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With the final prototype, I conducted A/B testing to compare the original trainer to the new one by observing students' ability to maneuver the scope with the trainers.
A report was generated to instruct WISER staff and students how to best implement and use the trainer to continuously develop skills while accounting for students' busy schedules.
Future Directions
Acknowledgments
I would like to thank Brandon Barber and Dr. Gartner for their guidance. I would also like to thank WISER and Tom Dongili for their feedback and insights.