Author: Lynne Burrow
Burrow, Lynne, 2018 The Development and Evaluation of a Sensor-Enabled Abdominal Palpation Simulator, Flinders University, College of Science and Engineering
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Abdominal palpation is a routine but critical diagnostic procedure performed in different clinical settings. It provides an initial diagnosis of a patient’s condition and determines the relative urgency and next steps for treatment. A clinician systematically palpates the regions of the abdomen to feel for tenderness, guarding, and underlying abnormalities such as masses or enlargement of organs. This involves both observing the patient’s response and feeling the response of their abdomen to different levels of applied forces in the different regions. Typically, an examiner performs a survey of the area with a “light palpation”, then followed up by pressing more firmly with an action called “deep palpation” to help find deeper masses and feel for some abdominal structures. This procedure requires a tactile sensitivity to gather information by applying pressure to the abdomen. It is a difficult technique to teach and assess and there can be significant variation between examiners. Simulation provides opportunities to overcome many of the limitations of previous training methods, to give students the ability to practice and develop adequate clinical skills to succeed.
The aim of this research was to develop an abdominal palpation simulator and test it across a range of participants to determine if it was sufficiently realistic for use as a training tool.
A simulator was developed using baseline abdominal palpation force data from a preliminary investigation. The abdominal palpation training simulator (AbSIM) consists of: a force platform able to measure the magnitude and location of applied force, a physical mould of a male torso comprising silicone rubber skin and foam layers, and an interface to a computer with custom software which records and displays the applied forces of the simulation session on a screen. AbSIM provides a physical abdominal manikin for students to palpate and provides feedback of the forces applied.
The proposed AbSIM was evaluated by conducting a trial with 144 participants with varying levels of experience (both medical graduates and medical students). Participants palpated the abdomen according to the clinical scenario while the system recorded the simulation data, then participants gave feedback on the simulator. 62.5% (CI: 54.4-70.0) of participants said that the simulator was sufficiently realistic to learn the technique. Data recorded showed variation in technique of participants in coverage, sequence, technique, and forces applied. This bespoke simulator provides a potential way to teach the sense of touch for abdominal palpation in medical students and graduates.
AbSIM, the abdominal palpation simulator, was constructed and developed as part of Lynne Langman’s (nee Burrow) Research Higher Degree PhD studies at Flinders University.
Keywords: abdominal, palpation, simulator, sensor-enabled
Subject: Engineering thesis
Thesis type: Doctor of Philosophy
Completed: 2018
School: College of Science and Engineering
Supervisor: Professor Karen Reynolds