Simulation of Image-Guided Intervention in Medical Imaging Education.

INTRODUCTION/BACKGROUND: Medical imaging education programs across Europe, despite their variability, include clinical practice as a guarantee of quality because learning in a clinical context is more effective and allows for constructive qualification of students. Learning in a clinical simulation context is a strategy to promote simulated clinical experience and assure patient safety. In this work, a learning experience, consisting of simulating a pacemaker implantation, implemented over 3 years with students pursuing the Medical Imaging and Radiotherapy degree at the University of Aveiro was evaluated. METHODS: A pacemaker implantation simulation with fluoroscopic support was performed with students (third year) pursuing the Medical Imaging and Radiotherapy degree at the Simulation Centre of our institution over 3 years (2016, 2017-2018), addressing all the simulation phases. An operating theater, video recording system, high-fidelity full-body manikin with remote control and monitoring, anesthesia, and fluoroscopic C-arm imaging equipment were used for the simulation. After the simulation activity, students completed a questionnaire evaluated the importance of this learning experience for their educational process. RESULTS: Overall, the mean score results were consistent, even considering the three independent groups (one for each academic year). Students considered this experience valuable for their education, strongly agreeing that the simulation environment helped their learning process and allowed them to acquire, consolidate, and deepen knowledge. Furthermore, they considered that it impressed on them the necessity to continue to improve their learning, and that they would like to participate in other simulation scenarios. DISCUSSION/CONCLUSION: This simulation activity was a valuable experience for the learning process of the students because it facilitated the acquisition and consolidation of knowledge. It also allowed the students to be aware of the importance of being engaged in their own education. The results were highly consistent over the 3 years, reinforcing the positive feedback from this experience.

Numerical simulation of breast reduction with a new knitting condition.

Breast reduction is one of the most common procedures in breast surgery. The aim of this work is to develop a computational model allowing one to forecast the final breast geometry according to the incision marking parameters. This model can be used in surgery simulators that provide preoperative planning and training, allowing the study of the origin of the errors in breast reduction. From the mathematical point of view, this is a problem of calculus of variations with unusual boundary conditions, known as knitting conditions. The breast tissue is considered as a hyperelastic material, discretized with three-dimensional finite elements for the body, whereas the skin is modelled with two-dimensional finite elements on the curved surface. Although the model is of low precision, we show that it is sufficient for a satisfactory prediction of breast reduction surgery results, allowing an analysis of errors frequently performed during the surgery and giving an understanding of how to avoid or correct them. Copyright © 2016 John Wiley & Sons, Ltd.