Physical Simulator

The learning design of the virtual simulation application, partnered with a physical simulator, is a perfect conduit to evaluate a learner’s clinical competency. Our system divides learning into four hierarchical processes that mirror Miller's pyramid: knowledge, application of knowledge, clinical skills competency, and clinical performance. This instructional design methodology is echoed across all four modules and was chosen for its flexibility. Our theory utilizes a strong instructional design methodology, with adult learning theories that will yield a positive clinical competency output through ubiquitous learning. The creation of both virtual and physical simulators provides a lifelike example of a clinical encounter where a novice learner can make mistakes and learn from past experiences without endangering patients. Each module course begins with an MCQ section with a threshold of 80% for passing (knowledge), virtual simulation (application of knowledge), post-evaluations with self-directed feedback (clinical skills), and the final physical simulator (clinical performance).

Equipment

• x1 Wood board 50x20cm
• x1 Felt 50x20cm
• x2 Sponge/ panty shield 50x20cm
• 3cm diameter plastic Pipe x 50cm long
• Sand
• Vegetable oil
• x2 Screws
• Super glue
• Hole punch
• x10 pins or nails
• x10 elastic bands
• Drill & drill bit (1mm less than the Schanz pins)
• Ex fix kit

Procedure

Step 1

Build the wooden base as per the Z-plasty and V-Y plasty modules. Use the wooden board, and x10 pins or nails for the sides (AmoSmile Physical Simulator)

Step 2

Make medulla

Cut x2 15-20cm of the pipe

Pack the pipe segments with a mix of sand and vegetable oil, ensuring that it is compacted as tightly as possible

Step 3

Place a 45cm x 10cm piece of sponge onto the wooden board

Step 4

Lay the x2 cut pipe lengths onto the sponge, which is on the wooden board. Ensure a 0.5cm gap is between the 2 pipes. These represent the bone ends with a fracture gap

Step 5

Secure the 2 bone end onto the wooden block with a 0.5cm gap between them

Use x1 screw on either lateral end of the pipes ensuring the screw is completely through the pipe and into the wooden board

Step 6

Lay a 45cm x 10cm sponge over the pipes and pipe gap. Glue if it raises on the edges

Step 7

Cut a 45 x 10cm piece of felt

Step 8

Punch x5 holes on both the long sides of the felt

Step 9

Lay the felt over the sponge, which is on top of the pipes

Step 10

Attach the felt onto the board using elastic bands looped through the punched holes

Reproducibility

We have developed a mobile app that guides learners through an entire curriculum, including step-by-step simulations and dynamic, customized training with competency tracking. Our physical simulator is low-cost, easily assembled, and entirely locally sourced, with the ability to simulate critical steps of the procedure in a self-directed, accessible, and clinically translatable manner. The application has been revamped several times to enhance UI/UX components and truly deliver a self-directed learning experience by adding 360 feedback to the assessment sections to direct the learner to areas needing more review. The build consists of wood, a felt material, a sponge, sand, vegetable oil, screws, drill bits, and a plastic pipe. All of these materials can be substituted for similar materials locally sourced.