Training Simulator for Epidural Needle Insertion

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DESCRIPTION (provided by applicant): In this Phase II program, Physical Sciences Inc. (PSI) proposes to develop a training simulator for epidural catheter insertion that combines features of a physical model and virtual reality simulation. The physical model will consist of a human torso mannequin. The torso will be covered with an artificial skin through which anatomical landmarks can be palpated to determine the location of needle insertion, as is done to patients. When a Touhy needle punctures the artificial skin, it will encounter, the novel, haptic feedback device, the feasibility of which was demonstrated in Phase I. This computer-controlled device calculates the location of the needle and applies the appropriate resistive force. The system will be designed so that the haptic feedback device can be mounted at different locations in the mannequin for simulation of epidural needle insertion at different intervertebral joints by both the median and paramedian approaches. This system will also allow simulation of other needle insertion techniques, such as spinal tap. In the Phase II Program, collaborators at the CIMIT simulation center will develop performance measurement algorithms and design a study to validate that performance on the simulator is correlated with clinical skill. The study will be conducted with residents of varying experience and attending anesthesiologists. Validation work will be accomplished with support from obstetric anesthesiologists at the Beth Israel-Deaconess Medical Center. When completed, the simulator will aid training medical personnel to deliver epidural anesthesia at several intervertebral joints for relief of surgical pain, chronic pain, and childbirth pain, as well as other needle insertion procedures. It will allow complex cases to be simulated, allow trainees to purposely make mistakes, and ease the anxiety of junior physicians treating patients.