Creation of a Novel 3D-Printed Amniocentesis Simulation Model and Impact on Resident Confidence

Abstract

Background: Non-invasive prenatal screening has decreased opportunities for diagnostic antenatal procedures during residency training. Commercially available models are often cost prohibitive while homemade models can be low fidelity and non-reusable. Objective: To create a training tool with realistic anatomy, tissue-specific tactile sensation, and cost-effective assembly for amniocentesis procedural technique practice and evaluate its impact on trainee confidence with performance. Study Design: Collaborating with biomedical engineering students, our team defined several characteristics to achieve a high-fidelity model: compatible with ultrasound, anatomically accurate, demonstrate tactile realism, endure repeat use, and be cost-effective. A 3-D printed model was created that satisfied fidelity guidelines after rigorous materials and imaging testing. Results: We implemented the model in the observed structured clinical exam for Obstetrics and Gynecology residents in which trainees (PGY2-4) performed an amniocentesis after guided practice with Maternal-Fetal Medicine faculty. Residents were given pre and post-simulation Likert scale surveys regarding confidence and satisfaction with the model. Descriptive analyses and paired t-test were used for analysis. 19 residents completed both pre and post surveys. Mean resident confidence in performing an amniocentesis increased from 1.6 to 3.2 (p<0.001, scale 1-5) after the practice session. Most residents (89.5%) strongly agreed that the model was easy to use and would use it to practice independently. Conclusion: This novel 3-D printed, ultrasound compatible, anatomically accurate, and cost-effective amniocentesis model provides high-fidelity procedural practice and improved trainee confidence. Models such as these have the potential to greatly impact skill development for rare procedures. Future directions include modifying this model for additional fetal procedures, such as cordocentesis.