Dynamic three-dimensional printing: The future of bronchoscopic simulation training?

High-fidelity models are required for technical mastery of bronchoscopic procedures in the fields of anaesthesia, intensive care, surgery and respiratory medicine. Our group has created a three-dimensional (3D) airway model prototype to emulate physiological and pathological movement. Developed from the concepts of our previously described 3D printed paediatric trachea for airway management training, this model produces movements created by injection of air or saline through a side Luer Lock port. The anaesthesia and intensive care applications of the model could include bronchoscopic navigation through narrow pathologies and simulated bleeding tumours. It also has the potential to be used to practice placement of a double-lumen tube and broncho-alveolar lavage among other procedures. For surgical training, the model has high tissue realism and allows for rigid bronchoscopy. The novel and high-fidelity 3D printed airway model with dynamic pathologies represents capability to provide both generic and patient-specific advancement for all modes of anatomical representation. The prototype illustrates the potential of combining the fields of industrial design with clinical anaesthesia.

Acquisition and Maintenance of Endoscopic Skills: Developing an endoscopic dexterity training system for anesthesiologists.

The acquisition and maintenance of essential psychomotor skills that are only required sporadically is a significant problem in medical training and practice. It is of particular relevance to anesthesiologists with regard to fibreoptic intubation, a technique that may be under-utilized despite its central role in the management of the difficult airway. Dexterity deficit due to current training models, dexterity decay due to lack of practice, and situational stress related to the clinical environment may combine to impede effective training and confident use of endoscopes in airway management. An educational resource (DexterÔ) has been developed to overcome these problems. Dexter is a non-anatomical, endoscopic dexterity training system designed to encourage practice and help establish and maintain a state of procedural readiness, even if clinical exposure to difficult airway situations is sporadic.

Acquisition and maintenance of endoscopic skills: developing an endoscopic dexterity training system for anesthesiologists.

The acquisition and maintenance of essential psychomotor skills that are only required sporadically is a significant problem in medical training and practice. It is of particular relevance to anesthesiologists with regard to fiberoptic intubation, a technique that may be under-utilized despite its central role in the management of the difficult airway. Dexterity deficit due to current training models, dexterity decay due to lack of practice, and situational stress related to the clinical environment may combine to impede effective training and confident use of endoscopes in airway management. We describe an educational resource (Dexter), which has been developed to overcome these problems. Dexter is a nonanatomical, endoscopic dexterity training system designed to encourage practice and help establish and maintain a state of procedural readiness, even if clinical exposure to difficult airway situations is sporadic.