Bioengineering seniors are creating simulators that physicians will eventually use to perfect their skills.
The finished mannequin-like objects will allow family practice and emergency medicine physicians to practice a procedure to diagnose gout and will allow surgeons to simulate repairing multi-level skin lacerations. But the whole process gives students an idea of what working in industry is like.
“Seniors in Bioengineering have a full year for design to have a more realistic design experience, which is quite unique,” said lecturer Jennifer Amos, who is teaching the two-semester Senior Design course where students are designing the simulators. “This is particularly useful in Bioengineering due to the restrictions in our field on FDA approval. We cover issues like systems and parametric design, Six Sigma, FDA approval, patents and other industry-relevant topics.”
Dr. Norman Estes
Four students are designing and building a model of an arm that simulates a multi-layer laceration. Dr. Norm Estes, a surgeon who directs surgical training at the University of Illinois College of Medicine at Peoria, is acting as the client for the project. Dr. Norm Estes, a surgeon who directs surgical training at the University of Illinois College of Medicine at Peoria, is acting as the client for the multi-layer laceration simulator project.
“These students show a lot of motivation in terms of how to approach a problem,” Estes said, adding that he was impressed with their eagerness to jump into the design phase.
The students’ model will be used to train surgeons or physicians who staff rural emergency rooms to repair a complex, multi-layer extremity laceration, like one caused by a farm injury or automobile accident. These types of accidents are common in rural farming communities, and patients in those areas are often referred to a larger, distant hospital.
Students in the group designing the multi-level laceration simulator, from left to right, Christina Winter, Lisa McGregor, Shelby Svientek and Megan Silas.
Students are creating a model to simulate irregular edges, realistic skin, fat, connective tissues, muscle and subcutaneous tissue. The model must also be durable, easily transported and reusable. It will allow physicians to practice closing, trimming and sewing together the wound, giving them more skills and confidence to do it correctly, Estes said. Students will also develop a manual, a video training and an evaluation system to complement the model. If implemented, physicians would mail it back to experts to get feedback on how well they closed the wound and suggestions on how to improve.
Estes plans to allow the students to examine the lower extremity of a hog to feel the different tissues so they can recreate them accurately.
The model will be tested at sites in southern Illinois or through the American College of Emergency Physicians.
Students in the group designing the multi-level laceration simulator
Shelby Svientek, a senior in bioengineering from Sparta, Ill., said she is interested in developing the model because she is from southern Illinois and knows there is a need for physicians who can close multi-layer lacerations at rural medical centers.
“I know a lot of people that would get their hands caught in tractor equipment, or they would get too close to a blade and get their leg sliced,” she said.
Students may be able to observe deep tissue lacerations being closed at Carle Clinic in Urbana and may possibly do cadaver work to aid in creating their simulators.
Svientek’s group plans to include tubes that would simulate blood vessels that would contain liquid, and they would also like their model to allow physicians to practice closing a vein. Her group will use materials like latex, PVC pipe and foam to build the model.
In another project for the same class, four different students are creating a model that simulates gout and will look and feel like an inflamed big toe, have bony and soft tissue architecture of a big toe and contain fluid that can be aspirated.
Gout is a common and painful disease that often causes a tender and inflamed big toe. Physicians must draw fluid from the inflamed joint in order to determine if gout is causing the inflammation and not another condition like infectious arthritis. The fluid is analyzed under a microscope to determine if uric acids are present, which indicates the patient has gout.
Since the great toe is a difficult joint to tap, this simulator would give physicians an opportunity to practice. Requirements of the simulator are that has the “pop” felt when entering a joint capsule, can be reused with or without replacement parts and will allow physician performance to be assessed.
“Gout is so painful that it hurts for a breeze to blow over it,” Amos said. Physicians need to draw fluid correctly the first time because patients might not allow them to do it a second time, especially since physicians must use a long biopsy needle.
Rheumatologist Thomas Santoro, also from the U of I College of Medicine at Peoria, is acting as the client for the Gout Tap Simulator.
“While the rationale for tapping the big toe is readily appreciated by the clinician, performing the task is not easily accomplished,” he said. “The joint is quite small - 1 to 2 mm in width, 4 to 5 mm in length and 1 to 2 mm in depth – so it takes considerable expertise to enter the joint space successfully and obtain fluid.”
Students in the group designing the gout simulator, from left to right, Matt Pinto, Lauren Sheehy, Jaclyn Spitz and Rosa Ventrella.
The current model only allows physicians to simulate actually hitting the joint with the biopsy needle, but these students will create a model that includes fluid, said Matthew Pinto, a senior from Midlothian, Ill. who is in the group designing the gout simulator. Students in the group designing the gout simulator, from left to right, Matt Pinto, Lauren Sheehy, Jaclyn Spitz and Rosa Ventrella.
Pinto said Santoro wants the simulator to “be as anatomically correct as possible, and the joint space that he wants us to fill up with fluid is fairly small.” It is, in fact, smaller than a cubic inch.
A goal is for the gout simulator to be reusable, so Spitz said they may create a refillable or replaceable sack to hold the fluid.
The existing simulator is a plastic toe. When a needle goes in, a light comes on, and it isn’t very realistic simulation of the experience of drawing fluid from the inflamed joint.
“Our goal is to be as realistic as possible so that the bone is as hard as bone is and the skin feels like skin,” said Jaclyn Spitz, a senior from Buffalo Grove, Ill. who is also on the gout simulator team.
Santoro and three rheumatologists and/or residents in internal medicine or emergency medicine will give students feedback on their design and prototype.
These finished simulators will be used in the University of Illinois College of Medicine at Peoria’s Simulation and Education Center.
Students are using this model of foot bones as a starting point to design their gout simulator.
Students are using this model of foot bones as a starting point to design their gout simulator.The two projects described are just two of 11 different simulators that Amos’ 42 Senior Design students are creating. Students create a detailed plan for their projects in the fall and an initial prototype, and they then test and improve it in the spring.
Amos said this collaboration could be the just the start of the University of Illinois College of Medicine at Peoria and the Bioengineering Department collaborating on more projects, like mock clinical trials and research partnerships.
In the course, other applicable issues are discussed, like paperwork for patents.
“I think this class tries its best to show what it would be like to work in industry,” Pinto said.