Title: Improving regional anaesthesia education using 3D printing
Funder: Royal College of Anaesthetists

Abstract: A recent comprehensive review on the applications of three-dimensional printing in anaesthesia revealed exciting innovations and indicated an increasing interest in the use of the technology. Its potential role in facilitating educational events was explored briefly, however further literature searches revealed a paucity of relevant work focused on procedural simulation and phantom modelling. Regional anaesthesia techniques are correlated with a steep learning curve, demanding time consuming bed side teaching, and expose the patient to risks due to inexperience such as failure, which can furthermore undermine trainee confidence. I propose a project to assess the feasibility of employing three-dimensional printing in producing realistic training models which are anatomically accurate, cost effective, reproducible, and reusable. Simulation is known to improve regional block performance in the early training period. My goal is to prove that a non-commercial simulation model can be used to teach trainees effectively, reducing the risk of complications or block failure, in addition to improving theatre efficiency by reducing the time consumed instructing basic techniques. To achieve this, an initial assessment of the current methods used in regional anaesthesia training at the local institution will be performed. Furthermore, an investigation into the current training/efficiency issues with regional block performance in theatres will take place by way of an electronically delivered survey. A phantom model which will physically simulate an ultrasound image and needling for select regional ‘plan A’ blocks (initially upper limb) will be designed, printed, constructed, and refined. This will be achieved by utilising publicly available axial CT data, open source image conversion software, and a consumer grade 3D printer with mainly biodegradable polylactic acid (PLA) filaments forming moulds for gelatine/silicone fragments. The resulting model will be tested for realism by exploring metrics such as ultrasound accuracy and tactile feedback. Its’ use as a training device will be verified/compared with commercial products and typical didactic methods through Consultant and trainee exposure, using investigational feedback tools, and via a locally delivered regional anaesthesia teaching programme. Based upon current experiences with 3D printing, approximately 6 months of experimentation and refinement will be necessary before a useable model is ready for the second stage of the project: verifying its’ use as a teaching tool. I also hope to inspire national collaboration and the formation of 3D printing working groups within the NHS, to further explore the utility of the technology in clinical education. Although more accessible now than ever before, 3D printing still requires significant financial resources as there are justifiably substantial fixed and consumable costs. Whilst self-funding, I am currently limited to small feasibility demonstrations and experimentation with a compact stereolithography (SLA) printer. A grant would help cover a significant portion of these costs, enabling me to fulfil the goal of economical fabrication of anatomically correct models and then demonstrating their effectiveness as an educational tool. Specifically, funding would allow for the purchase of an appropriately sized consumer grade fused deposition modelling (FDM) printer and enough filaments/resins to produce both experimental drafts and the final models.


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE