Inexpensive, High-Fidelity Model to Simulate Ultrasound-Guided Pericardiocentesis for Cardiology Resident Training

• Published in: Canadian journal of cardiology 2019-11, Vol.35 (11), p.1600-1603
• Main Authors: Belliveau, Daniel J., Moeller, Andrew, Ramer, Sarah
• Format: Article
• Language: English
• Subjects: Animals; Cardiac Tamponade - surgery; Cardiology - education; Clinical Competence; Computer Simulation - economics; Costs and Cost Analysis; Education, Medical, Graduate - economics; Education, Medical, Graduate - methods; Humans; Internship and Residency; Models, Animal; Pericardiocentesis - education; Pericardiocentesis - methods; Surgery, Computer-Assisted - education; Surgery, Computer-Assisted - methods; Swine; Ultrasonography - methods
• ISSN: 0828-282X; 1916-7075
• DOI: 10.1016/j.cjca.2019.05.029

Adult cardiology residency training programs require residents to become proficient at many procedural skills, including pericardiocentesis. However, in many programs, opportunities to perform this procedure are limited. Expensive mannequins have been developed to assist with teaching this skill, however, the associated cost make them impractical for many programs. We hypothesized that a low-cost, high-fidelity pericardiocentesis model could be constructed using items easily accessible to any consumer. We describe a pericardiocentesis model made from pork skin, pork ribs, gelatin, a plastic bag, and an avocado. Total cost was less than CAD$40.00 and preparation time was approximately 60 minutes. The model was evaluated with a survey by 14 senior cardiology and critical care residents as well as 3 experienced senior cardiologists. Imaging results from the ultrasound revealed that the target fluid was easily visualized and all trainees were successful in aspirating fluid. The model was durable and withstood more than a dozen punctures, demonstrating its ability to train multiple residents. Respondents to the survey reported the model as highly realistic. All cardiology residents agreed or strongly agreed that the model should be incorporated into their formal curriculum. This study shows that a low-cost, high-fidelity model can be constructed and easily implemented into the formal curriculum of adult cardiology residency programs. It allows residents the opportunity to practice pericardiocentesis in a low-risk setting on a high-yield device. Les programmes de résidence en cardiologie chez l’adulte exigent des résidents qu’ils acquièrent les compétences nécessaires pour effectuer de nombreuses interventions, dont la péricardiocentèse. Toutefois, dans bon nombre de programmes, les occasions d’effectuer cette intervention sont rares. Des mannequins très chers ont été mis au point pour faciliter l’enseignement de cette intervention, mais leur coût représente un obstacle pour de nombreux programmes. Nous avons émis l’hypothèse qu’il serait possible de créer un modèle de péricardiocentèse très réaliste et à faible coût en utilisant des produits que tout consommateur pourrait facilement se procurer. Nous décrivons un modèle de péricardiocentèse créé à partir de peau de porc, de côtes de porc, de gélatine, d’un sac en plastique et d’un avocat. Le coût total a été inférieur à 40 $ CA et la préparation a nécessité environ 60 minutes. Le modèle a été évalué par un sond