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Educators print body parts for clinical training

Program saves money, provides more opportunities to practice

Practice makes perfect. Skills like shooting free throws or painting are straightforward, easy, and the equipment needed to learn them is inexpensive. But what happens when the skill involves buying expensive fake body parts to train the next generation of doctors and nurses? 

Two caregivers at Saint Joseph Hospital have the answer: They make their own. 

Gerard Salame, MD, is an internal medicine specialist with SCL Health Medical Group, now part of Intermountain Health, and a faculty member at Saint Joseph Hospital’s physician residency program. Lisa Maskus is a simulation lab educator at Saint Joseph Hospital, now part of Intermountain Health.  

Both have long relied on life-like medical mannequins that can breathe, blink and bleed under computerized command to train physicians in residency or existing clinicians. The educators buy fake body parts from online companies for procedural training. However, these specialized manufactured body parts are expensive, and they need to be used sparingly. In addition, parts wear out quickly. 

Hoping for a more cost-effective alternative, Maskus and Salame turned to a 3-D printer, ballistics gel and assorted other materials to more efficiently and effectively create the needed training materials.  

Maskus said doctors from the graduate medical education program explain the concept they want to teach such as an intraosseous infusion, which involves injecting fluid or medication into the marrow of a bone. A fake bone online costs about $2,000. Maskus can download free software and print a model for a few dollars. She then produces bones in large quantities.  

“It improves patient outcomes because it gives providers more chances to practice their skills in a safe environment,” she said.  

She prints adult and infant rib cages, hearts, spinal columns, and pelvis bones. The materials might be used by physicians, nurses, and other clinical staff for training.  

Dr. Salame focuses on teaching point of care ultrasound to the internal medicine residents. Also called POCUS, the procedure allows the physician to assess patients faster without having to take them to a different department for medical imaging. Point of care ultrasound also can help guide a physician in a procedure like gaining access to a vessel.  

To teach the medical residents how to perform a point of care ultrasound, he uses ballistics gel and other materials to simulate tissue. He might add a tube to simulate a vein and other materials for coloring and texture.  

He created a cardiac cube to simulate left and right heart ventricles. Residents learn to move the ultrasound probe around the structure to get the best picture of ventricles inside the cube. In the case of a procedure when residents insert needles, the ballistics gel is resealing so the structure can be used many times. The goal is for residents to think about the structures in three dimensions.  

The structures or 3-D printed training items are a good introduction for clinicians new to the procedure.  

Dr. Salame said expectations for creative, hands-on training using technology have increased among medical residents. He incorporates gamification, which means creating a series of challenges with points awarded for success and competition created among the teams. Recently at a medical education conference, participants worked through a zombie apocalypse and had to successfully diagnose the zombies’ condition with ultrasound to pass to the next level.