To Pack a Nose: High-Fidelity Epistaxis Simulation Using 3D Printing Technology

Abstract

Background: Initial management and stabilization of epistaxis is managed by a diverse offset of clinical providers with variable levels of training. Objective: To determine the anatomic and clinical fidelity and ease of use of a novel simulator for the training and assessment of epistaxis management skills. Study Design: Qualitative Research Study using expert questionnaire's for validation of a newly developed simulator. Methods: We performed a quasi-experimental intervention with 22 otolaryngology faculty and 10 trainees who independently evaluated the simulator. Data were collected in three phases: phase 1 (preliminary evaluation), phase 2 (final expert evaluation), and phase 3 (trainee evaluation). We designed a three-dimensional (3D) printed model from a de-identified patient computed tomography scan. Artificial blood was circulated through catheters to simulate bleeding from three distinct sites (sphenopalatine, Kiesselbach's plexus, and anterior ethmoid). Four domains were assessed: “Physical and anatomic attributes,” “Realism of experience,” “Ability to perform tasks,” and “Value and clinical relevance.” Internal structure and validity were measured with Cronbach's alpha and item outfit mean-square statistics. Results: Results from otolaryngology faculty showed very high median ratings for “Value of the simulator as a training tool” (4.0/4) and high ratings for “Relevance to practice” (4.0/4), and realism of experience (4.0/4). Responses from otolaryngology trainees demonstrated high value for clinical training (4.0/4) and high likelihood to recommend use for future trainees (4.0/4). Confidence in managing epistaxis before (1.0/4) and after (3.0/4) simulator use was statistically improved (P =.03). Conclusions: Using 3D printing technology, we created a novel simulator for epistaxis management. Preliminary evidence suggests the model is cost-effective, anatomically realistic, relevant to trainees' educational needs, and valuable as a training tool. Level of Evidence: 3 Laryngoscope, 132:747–753, 2022.