Abstract:

Introduction: The teaching of clinical examination skills is essential in training medical professionals. This has traditionally occurred using live patients, but such opportunities are diminishing due to i) restrictions on doctor-patient contact due to recent pandemic outbreaks ii) shift of medical care from inpatient to outpatient models iii) patients objecting to examinations by student doctors. Such issues have resulted in increased utilization of medical simulators, e.g. to simulate the rectal examination, surgery, delivery of a baby, etc. Simulators offer advantages including: i) unlimited student practice time, ii) experiential learning for the student without causing patient discomfort iii) comprehensive exposure to numerous disease conditions in a single setting. iv) objective settings for assessment purposes. Currently, cardio-respiratory simulators are the best developed and utilized, incorporating sophisticated functions and best approximating real-time scenarios. Although the abdomen features prominently in clinical medicine and medical education, simulators designed to teach abdominal palpation skills have not been developed, to date. Aims: To describe the creation of ABE the Tummy Dummy, an abdominal manikin designed to realistically simulate the abdominal examination and provide appropriate tactile feedback to the trainee. ABE contains interchangeable organs (liver, spleen, kidneys, gallbladder etc) of various sizes that can be inserted into the abdominal cavity, which the trainee can then palpate or ballott. Methods: We trialled a prototype of ABE the Tummy Dummy at our medical school, using it to teach 44 medical students to perform the abdominal clinical examination during the H1N1 outbreak of 2009. The students were split into groups of 6, and the sessions conducted over a period of 3 weeks. Feedback was obtained via a questionnaire to assess the students' learning experience using the two models, as well as compare the quality of the teachings done by the different tutors. Results: Feedback was positive, 93.2% opining that the NUS-TD was useful and 79.6% that it increased their confidence in performing the steps of the abdominal examination. Conclusion
Abdominal simulators can be adopted to impart palpation skills to medical students, in addition to using live patients with good clinical signs. We present the preliminary data from the pilot study, and will provide a live demo of ABE the Tummy Dummy. Details of Abe the Tummy Dummy will be available on www.abe-the-tummydummy.com

Keywords:

Manikin, abdominal examination, simulator, novel.