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Federación Latinoamericana de Simulación Clínica y Seguridad del Paciente

2020, Number 3

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Simulación Clínica 2020; 2 (3)

Design of a patient simulator for cardiac auscultation

Jiménez-Ángeles L, Rosario-Rojas A, Viaña-Fragoso SA

Language: Spanish
References: 19
Page: 147-154
PDF size: 431.54 Kb.


ABSTRACT

The use of simulators in medical training allows the reproduction of different physiological conditions in a controlled, reproducible and quantifiable environment; this favors the teaching-learning process without risk to the users. This document describes the design and development of a patient simulator that makes it possible to reproduce the process of cardiac auscultation. The proposed simulator consists of an anatomical model of the human body with anthropometric measurements similar to those of an adult man and an electronic circuit that controls the heart sound associated with the site where the auscultation is performed. The anatomical model was built by modeling the ribcage and skull. The synthetic skin was built with silicone and adjusted to the ribcage with flexible expandable foam to simulate the muscles and the adipose tissue. The electronic circuit controls the audio reproduction modules and allows the storage of different and varied physiological conditions. Also, the electronic circuit controls five tactile pressure sensors which activate light indicators when the placement of the stethoscope in the auscultation focus is correct. A competitive advantage of our development with respect to the commercially available ones is the flexibility to make modifications in its operation, structure and conformation; besides the low cost associated to its manufacture. These features will allow expanding the functionality to record and monitor various physiological variables such as those related to electrical muscle activity, brain, respiratory, lung or mechanical. The future validation of the proposed simulator will allow to evaluate its capacity to increase the skills of doctors in training.


REFERENCES

  1. Fang JC, O’Gara PT. The history and physical examination: an evidence-based approach. In: Mann DL, Zipes DP, Libby P, Bonow RO, editors. Braunwald’s heart disease. 10th ed. Philadelphia: Elsevier Saunders; 2015. pp. 95-113.

  2. Sztajzel JM, Picard-Kossovsky M, Lerch R, Vuille C, Sarasin FP. Accuracy of cardiac auscultation in the era of Doppler-echocardiography: a comparison between cardiologists and internists. Int J Cardiol. 2010; 138: 308-310.

  3. Kelder JC, Cramer MJ, van Wijngaarden J, van Tooren R, Mosterd A, Moons KG, et al. The diagnostic value of physical examination and additional testing in primary care patients with suspected heart failure. Circulation. 2011; 124: 2865-2873.

  4. Mangione S, Nieman LZ. Cardiac auscultatory skills of internal medicine and family practice trainees. A comparison of diagnostic proficiency. JAMA. 1997; 278: 717-722.

  5. Mangione S. Cardiac auscultatory skills of physicians-in-training: a comparison of three English-speaking countries. Am J Med. 2001; 110: 210-216.

  6. Vukanovic-Criley JM, Criley S, Warde CM, Boker JR, Guevara-Matheus L, Churchill WH, et al. Competency in cardiac examination skills in medical students, trainees, physicians, and faculty: a multicenter study. Arch Intern Med. 2006; 166: 610-616.

  7. Gaba DM. The future vision of simulation in health care. Qual Saf Health Care. 2004; 13 (suppl 1): i2-i10.

  8. Okuda Y, Bryson EO, DeMaria S Jr, Jacobson L, Quinones J, Shen B, et al. The utility of simulation in medical education: what is the evidence? Mt Sinai J Med. 2009; 76 (4): 330-343.

  9. Berkenstadt H, Ziv A, Gafni N, Sidi A. The validation process of incorporating simulation-based accreditation into the anesthesiology Israeli national board exams. Isr Med Assoc J. 2006; 8 (10): 728-733.

  10. Reis S, Guimarães P, Coelho F, Nogueira E, Coelho L. 2018 Global Medical Engineering Physics Exchanges/Pan American Health Care Exchanges (GMEPE/PAHCE) Porto, Portugal: IEEE; 2018. A framework for simulation systems and technologies for medical training; pp. 1-4.

  11. Al-Elq AH. Simulation-based medical teaching and learning. J Family Community Med. 2010; 17 (1): 35-40.

  12. Karnath B, Thornton W. Auscultation of the heart. Hospital Physician. 2002; 38 (9): 39-45.

  13. Gordon MS. Cardiology patient simulator. Development of an animated manikin to teach cardiovascular disease. Am J Cardiol. 1974; 34 (3): 350-355.

  14. Champagne MT, Harrell JS, Friedman BJ. Use of a heart sound simulator in teaching cardiac auscultation. Focus Crit Care. 1989; 16 (6): 448-456.

  15. Takashina T, Masuzawa T, Fukui Y. A new cardiac auscultation simulator. Clin Cardiol. 1990; 13 (12): 869-872.

  16. Akins R, Ho H. Outcomes of using heart sound simulator in teaching cardiac auscultation. Can Med Educ J. 2010; 1 (1): e46-e50.

  17. Butter J, McGaghie WC, Cohen ER, Kaye M, Wayne DB. Simulation-based mastery learning improves cardiac auscultation skills in medical students. J Gen Intern Med. 2010; 25 (8): 780-785.

  18. McKinney J, Cook DA, Wood D, Hatala R. Simulation-based training for cardiac auscultation skills: systematic review and meta-analysis. J Gen Intern Med. 2013; 28 (2): 283-291.

  19. Medical Expo. Simuladores de pacientes de auscultación. Consultado en: https://www.medicalexpo.es/fabricante-medical/simulador-paciente-auscultacion-15050.html




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