Background : Emergency department thoracotomy is a high risk, potentially life saving procedure, which is rarely performed. Thus simulation training is key. High fidelity trainers are feature rich, but expensive. Low-fidelity trainers are less expensive and easier to maintain. We postulated than an inexpensive, easy to reset, low fidelity trainer would allow more opportunities for practice, and still be effective. This may have more impact in resource poor learning environments, especially low and middle income countries.
Purpose/Objective : To design and fabricate a low cost, simple to use emergency department thoracotomy trainer from easily acquired materials, and create a curriculum for novice to intermediate learners. The trainer provides platform deliberate practice and focuses on procedural skills and technique.
Methods : Our curriculum was delivered by one attending to three learners in a 30 minute session. It contained: pretest, instructor demonstration, practice and post-test. The learners each practiced on the trainer, one at a time. When not performing the procedure, the learners reviewed the steps mentally. The trainer contained enough structural detail to ensure all steps in the procedure were performed (rib spreader insertion, delivery of heart, etc.), and was constructed out of easily acquired material.
Outcomes : After the training session all learners were able to successfully order all procedural steps correctly, felt they understood the procedure better, and felt more confident. We attributed this to a novel trainer design and a simple but specific curriculum. Both gave each learner the chance for deliberate practice in a focused training session. The trainer was effective and easy to build and maintain.