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Ped.IT : Pediatric Evaluation Device Intended for Training
Revolutionizing the Pediatric Physical Examination through SimulationZachary Henderson, Minsuk Kwak, Kshitij Manchanda, & Michelle Thorson
Department of Bioengineering, Rice University, Houston TX, 77005Email: ricepedit@gmail.com
Background Physical examination skills are essential in order to assess the
health of pediatric patients. Almost 50% of medical students are do not receive sufficient
training for physical exam.1
Preparedness limited by: Patient variability Patient safety and comfort Rare disease occurrence Subjectivity in patient assessment
Medical simulation is an effective training tool.2,3
Current use of medical mannequins is limited by: Simulating adults in trauma situations only High cost ( > $150,000)
Our objective is to create a full-body pediatric mannequin that simulates conditions which are detectable by palpation during a physical exam in order to improve medical training.
Design Criteria Full body mannequin of average 6-10 year old
Correct body dimensions (100-115 cm) Correct organ sizes4
Low cost (<$2,500) Three integrated organ systems
Liver (normally 10-12 cm) Spleen (normally 7-9 cm) Lymph Nodes (normally 1-2 cm)
Simulates both normal and abnormal conditions related to each organ system
Realistic feeling skin Modular design for additional features and organ systems
Mannequin Design
References
Testing and Results Preliminarily surveyed Texas Medical Center physicians three times to
test the following on a scale of 1 (worst) to 5 (best): Accuracy of organ size Ability to feel abnormal organ conditions Realism of organ feel Realism of skin
Conclusions Innovation leads to:
More affordable mannequin (<$2000) Ability to simulate normal and a range abnormal organ
conditions shown by independent study More realistic mannequin skin/feel compared to
industry standards Ped.IT technology improves mannequin realism and
qualitative medical training to enhance clinical skills of medical professionals, in turn, ensuring better pediatric clinical care.
AcknowledgementsWe thank our mentors Dr. Jennifer Arnold, Dr. Amy Middleman, Dr. Renata Ramos, and Dr. Maria Oden for guidance throughout the project. We thank the OEDK for providing resources and space to conduct our design. We thank the Texas Children’s Hospital Simulation Center for providing additional support and space for testing. We also thank Laerdal for kindly donating a Nursing Kid pediatric mannequin for us to modify.
1. Bass, E.B. et al. Do clerkship directors think medical students are prepared for clerkship years? Acad Med. 79:56-61, 2004.
2. Devitt, J.H., Kurrek, M.M., Cohen, M.M., and Cleave-Hogg D. The validity of performance assessments using simulation. Anesthesiology. 95:36-42, 2001.
3. Tsai, T.C., Harasym, P.H., Nijssen-Jordan, C., and Jennett P. Learning gains derived from a high-fidelity mannequin-based simulation in the pediatric emergency department. J Formos Med Assoc. 105:95-98, 2006.
4. Netter, F.H. Atlas of Human Anatomy. Philadelphia: Saunders Elsevier, Inc, 3006, 548.
Electronic Control System- Voltage controlled actuators, located in chest
cavity, move liver and spleen to simulate abnormal conditions
- User controls organ movement through National Instruments LabVIEW VI
Actuator shown with liver with actuator connector LabVIEW VI Front Panel
Internal anterior cervical chains shown
Liver
Spleen
Neck Region- Enlarged lymph nodes- Exterior made from
Dermasol, bed foam- Lymph nodes- varying sized
balls attached by wire
Skin- Thin sheet of realistic feeling
Dermasol coated in powder
Shell- Modified Nursing Kid
mannequin shell from Laerdal
Heart and Lung Sounds- Simulate pediatric heart and
lung sounds at specific landmarks
- Emits VitalSim® sounds through external speakers
Abdominal Region- Simulate enlarged spleen and liver- Spleen created from taped Z-FLO bags- Liver created from tightly wrapped
Tempur-Pedic with firm edge- Internal structure made of Dermasol
and Tempur-Pedic
Battery Life Indicator
Organ Positioning Control
Autosave function
Record tracking
High scores noted for skin realism, organ condition, location, and feel on final, large-scale survey
Survey Participants
1 10
2 10
3 36
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