SIMULATION IN MEDICAL EDUCATION:

Simulation is an important methodology in bridging the gap between theory and practice
in medical education. Simulation-based education (SBE) provides a structured, learner-
centered environment in which novice, intermediate, and advanced practitioners can
learn or practice skills without causing harm to patients. It has been described as a key
driver of patient safety, and even as the patient safety laboratory of the
future. Simulation based medical education can be a valuable tool for the safe delivery of
health care. Following are some simulators that are designed to help medical students.

1. HUMAN PATIENT SIMULATOR (HPS):

INTRODUCTION:
HPS is designed specifically to support anesthesia and medical gases with patent
cardiovascular, respiratory, neurological and pharmacological modeling. The HPS
interfaces with real clinical monitors and ventilators, and automatically responds to the
administration of real anesthetic gases, oxygen therapy and drugs/medications. HPS
creates realistic learning experiences that replicate the complexities of human
physiology with reactive eyes, heart and breath sounds, palpable pulses and a myriad of
other features.

HARDWARE:
HPS equipment consist of HPS mannequin, Umbilical assembly, HPS lab rack, Touch Pro
monitor, OxSim, Monitor interface, Wireless microphone and receiver, Anesthesia
delivery system and wide variety of different kits.
1. HPS MANEQUIN:
HPS mannequin is a human patient of height 5ft , 11 inches and weight 75 pounds
(34 Kg). Fully operational in supine and lateral positions.

2. UMBILICAL ASSEMBLY:
The umbilical assembly is a long, bundled system of hoses and an electrical cable
attached to the HPS mannequin in the perineum area. The Umbilical assembly
attaches the mannequin to the HPS lab rack.

3. HPS LAB RACK:

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 The HPS lab rack is a hub of communication, power and pneumatics for the HPS. It
contains a central power supply, lung bellows and other essential components that
drive the simulator’s physical responses.

The following components are exposed at the back of the rack:

MUX 6 - An open serial port. May be used to connect the TDCK.
MUX 10 - An open serial port.
Exhaust Port - Used for scavenging anesthetic gases.
Audio Out - Enables the simulator’s audio outputs to be connected directly into an audio
system.
Genitourinary Pump - Forces water in and out of the mannequin through the system
hoses.
SpO2 Probe Port - Provides communication between the OxSim and the rack.
Bar Code Reader Port - Provides communication between the Bar Code Reader and the
rack.
Flow Meter - Measures the flow of the fluid to the chest tube and pericardiocentesis
features of the HPS.
Power Switch - Toggles simulator power on and off.

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The upper back of the rack also contains the drug recognition system, which measures
the volume displaced when drugs are given and pushes fluids from the drug system into
a collection bag.

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The following components can be accessed from the front of the rack: Sim Cube* -
Processes noninvasive blood pressure (NIBP) data from the software and drives the
mannequin’s physical responses so patient monitoring equipment may be used to
measure NIBP. Syringe Pump - Installed in the rack when the anesthesia system option is
in place. Delivers liquid anesthetic agents to a vaporizer before they are sent to the
mannequin, providing a realistic exhalation of agents. The syringe pump can also be
accessed via the anesthesia delivery system panel (see The Anesthesia Delivery System
Panel on page 13). Vaporizer - Installed in the rack when the anesthesia system option is
in place. Evaporates anesthetic agents before sending them to the mannequin. Bellows -
Provide the lung functionality of the HPS system. Mass Flow Controllers (MFCs) - Control
the flow of O2 , CO2 , N2 and N2 O to the mannequin. Gas Analyzer - Analyzes the gases
going into and flowing out of the mannequin. MUSE Universal Simulator Engine Circuit
Boards - Control various components of the rack.

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4. TouchPro Monitor:
HPS The optional TouchPro Monitor is a flat-panel, touchscreen monitor that
connects wirelessly to the Instructor Workstation and is used to run the TouchPro
software.
5. OxSim:
The OxSim is used to provide SpO2 data to the monitoring equipment used during
the simulation session. A standard SpO2 finger probe can be placed on the Index to
obtain an SpO2 reading for a virtual patient.

6. Monitor Interface:
The monitor interface is used to connect the simulator to a standard clinical monitor,
allowing for the display of a wide range of patient parameters.

7. Wireless Microphone and Receiver:

The wireless microphone and receiver are used for the patient voice feature of the
HPS system. The receiver is housed inside the rack. The wireless microphone
includes an adjustable lapel clip, volume control and mute.

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 8. Replacement Kit:
The Replacement Kit includes the IV Arm Kit, Trauma Features Kit, Airway Kit and
Genitourinary (GU) Kit. The items contained in each kit are listed below. IV Arm Kit •
Venous Tubing Splicing Kit • 140 mL syringe and IV solution sets
9. Trauma Features Kit :
• Chest tube foam inserts • Chest tube receptacles • Chest tube priming hose •
Diagnostic peritoneal lavage abdominal insert • Standard abdominal insert Airway Kit •
Spare neck skins • Silicone spray • Spool of red airway tape Genitourinary (GU) Kit •
Interchangeable male/female genitalia • IV solution set
10. Anesthesia Gas Accessory Kit:
The kit contains regulators and hoses to connect carbon dioxide, oxygen, air, inert gas
and carbon dioxide to the HPS Lab Rack.
11. Anesthesia Delivery System:
Allows the use and detection of real anesthetic agents

SOFTWARE:
HPS is operated by using a software named, MUSE.
The dashboard features a patient image, conditions and medications, streaming data
from clinical monitors, a menu of Simulated Clinical Experiences (SCEs) and a timeline.
The patient’s physiology and SCE can be preset so an instructor can focus on teaching.

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 2. CARDIOLOGY PATIENT SIMULATOR:

Auscultation (based on the Latin verb auscultate "to listen") is

listening to the internal sounds of the body, usually using
a stethoscope.

Auscultation is a fundamental approach to cardiac patients, performed widely from

general practitioners to cardiologists. Repeated practice is a necessity for learners to
differentiate various heart sounds and murmurs. However, opportunities to learn with
real patients are limited and could be insufficient. Simulator "K" offers hands-on
experience in a diversity of cases. Simulator "K" contains 88 cases; 12 cases of normal
heart sounds, 14 cases of heart disease simulations, 10 cases of arrhythmia simulations
and 52 cases of ECG arrhythmia simulations. Sounds are recorded from actual people
and reproduced using a high-quality sound system. An actual stethoscope can be used.
Auscultation sites corresponding to heart valves are located precisely on a life-size
manikin body molded from an actual person.

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HARDWARE:
Hardware includes the following components:
A. Main unit cardiology model
B. PC/Keyboard/Mouse
C. Main monitor
D. Ribs sheet
E. Instruction manuals
F. Control unit
G. Speakers

D E

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 F G

MODES OF CARDIOLOGY PATIENT SIMULATOR:

Cardiology Patient Simulator "K" has two variations of cardiological examination training
systems, MODE 1 and MODE 2.
MODE 1 (36 cases):
MODE 1 allows the trainings in bed side cardiological examination that are listed below. .
1. Auscultation of heart sounds 4. Arterial palpation 2. Electrocardiogram (ECG) 5.
Observation of jugular vein 3. Respiration (pulmonary sound, abdominal movement) 6.
Apex beat palpation
MODE 2 (52 cases):
MODE 2 is for arrhythmia simulation. 1. Auscultation of heart sounds 2.
Electrocardiogram (ECG)
ASCULATION SITES:
In all cases, auscultation can be performed at the four primary cardiac auscultation sites
(Aortic, Pulmonic, Tricuspid and Mitral). Auscultation of first sound (S1) and second sound
(S2) can be learned in relation to synchronized electrocardiogram, arterial pulses and
jugular venous waves.
Auscultation sites are located on the model as
A Aortic area
P Pulmonic area
T Tricuspid area
M Mitral area
Place the chest (ribs) sheet matching the position of clavicle. The sheet facilitates the
understanding of auscultation sites.

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SOFTWARE:
The cardiology patient simulator uses K2 simulation software, the software is already
installed in the PC and the main monitor. The operation scree is show below.

3.VICTORIA “MATERNAL AND NEONATAL SIMULATOR:

Victoria is the most lifelike and versatile maternal patient simulator. Victoria can simulate
low and high-risk deliveries with an endless variation of clinical presentations and she
can do so with precise repeatability. The patented fetal delivery system, powerful control
software and a library of pre-programmed scenarios combine to allow learners to resolve
situations in a safe environment, improve performance in specific situations and gain
valuable hands-on experience.

FEATURES AND FUCTIONS:

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 1. INTERACTIVE EYES: Victoria’s new eye movement and automatic tracking features
can simulate impaired eye motion to illustrate stroke, head trauma, drug use,
disease, cranial nerve impairment, and other eye diseases and conditions.

2. SUPPORTS REAL MONITORING DEVICES

Victoria supports the widest range of medical diagnostic equipment of any tether
less maternal and neonatal simulator, allowing participants to practice equipment
setup, operation, and data interpretation.
 Fetal monitor • ECG monitor • Defibrillator • Pulse oximeter • Capnograph • NIBP
monitor

3. • C-Section delivery capability supports the use of real surgical instruments for
cutting and suturing the abdominal and uterine walls
4. Abdomen supports the placement of real ultrasound and toco transducers to
monitor fetal activity in real time
5. Fetal heart tone moves with fetal descent
6. Palpate contractions manually
7. Victoria can simulate low and high risk deliveries with an endless variation of
clinical presentations and she can do so with precise repeatability
PRE-PROGRAMMED SCENARIOS:
1. NORMAL DELIVERIES
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 2. SHOULDER DYSTOCIA

3. C-SECTION DELIVERIES

4. BREECH DELIVERIES

HARDWARE:
Hardware includes the following
• Active birthing baby
• Integrated automatic drug recognition
• 20 Programmable Drug Recognition Syringes with labels
• Wireless Simulator Control Tablet PC with rugged bump case
• UNI® Simulator Control Software with Lifetime License
• 45+ Preprogrammed scenarios with Lifetime License

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• Automatic Mode control license
• Streaming voice headset
• Touchscreen vital signs monitor
• RF communications module
• USB wireless router
• Mother and baby battery chargers
• User guide and quick start guide
• Instructor and student training guides
• Palpation abdominal cover
• Contraction abdominal cover
• C-section abdominal cover
• Postpartum abdominal cover
• 2 umbilical cords
• 2 precut umbilical cords
• Placenta
• Epidural insert
• C-section baby
• 2 C-section abdominal skins
• 2 C-Section uterine walls
• Healthy PPH perineum
• Midline episiotomy suture trainer
• Mediolateral episiotomy suture trainer
• Hospital gown, baby head cap, receiving blanket and diaper
• Manual blood pressure cuff
• 2 baby delivery rings
• Birthing baby cradle
• Delivery rods
• Bladder
• NIBP calibration kit

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 3. VICTORIA’S NEWBORN:
Victoria’s birthing baby is a beautifully proportioned, full-term baby with realistic size and
weight, a soft and supple skin, and programmable vital signs. An endoskeleton provides
human-like joint articulation and resistance when assisting the fetus during the delivery.
These innovative features will provide your participants with the most realistic simulated
childbirth experience yet
FEATURES OF VICTORIA’S NEWBORN:
High-idelity full-term baby with realistic size and weight
• Orientation sensors in the body report internal and external rotation and the position of
the head relative to the body
• Anatomical landmarks include palpable fontanels and sutures
• Natural and graceful extension and rotation of the fetal head during birth
• Fully articulating fetal neck and limbs allow the practice of obstetrical maneuvers
• Smooth skin allows the use of vacuum devices or forceps
• Smooth full body skin with seamless joints
• Full-body endoskeleton provides postural support, range of motion and resistance
• Articulated spine, shoulder, elbow, hip, and knee joints with human-like range of
motion allows practice of newborn assessment techniques
• Multiple heart sound types and programmable heart rate
• Multiple respiratory sounds and programmable respiratory rates

• Crying with adjustable volume levels

• Central cyanosis with programmable intensity levels
• Visible head movement
• Programmable conditions for 1-minute APGAR assessment
• Detachable umbilical cord can be configured
• Heart and lung sound and palpable pulses to simulate cord complications

SOFTWARE:
Software used to control Victoria is UNI UNIFIED SIMULATOR CONTROL SOFTWARE. The
software includes the following features:
• Labor and delivery control screen with intuitive interface and options

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•Patient and fetal monitor
• Active 3D patient animation
• Scenario editor and player
• Laboratory report generator
• Activity log
• Comprehensive library of more than 45 preprogrammed labor and delivery scenarios

4. ARTHOMENTOR:
ARTHRO Mentor™ is an advanced arthroscopic training simulator. As the most effective
tool for arthroscopic surgery skills acquisition, the system reduces training time and
considerably improves the learning curve of the complex surgery techniques.

FEATURES:

 The simulator features a line of simulated procedures, combining fiberglass /

polyurethane anatomical models (shoulder, knee and hip) with 3D images
 Haptic sensation, to allow users to learn key aspects of the procedures.
 Interchangeable knee/shoulder/hip models.
• Moveable knee that can be extended/flexed and bent in Varus/Valgus movements.

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 • Shoulder arthroscopy in beach chair and lateral decubitus positions.
• Hip arthroscopy in supine and lateral decubitus positions.

 Robotic arms for a true-to-life dynamic force feedback.

 Height adjustable platform to achieve a realistic working position.
 Integrated storage for anatomical models.
 Handy tools hanger.
ARTHRO Mentor Modules:

 SHOULDER LABRAL REPAIR:

 HIP DIAGNOSTICS
 COMPLETE SHOULDER ARTHROSCOPY
 ADVANCED KNEE
 FAST- FUNDAMENTALS OF ARTHROSCOPIC SURGERY TRAINING.

Hardware includes:
 Detailed realistic anatomical models
 Realistic surgical instruments adapted for use with the simulator
 Haptic device
 Elevated platform and adjustable tools location for maximal comfort


Software includes:
Customizable curriculum incorporating training and didactics.
• Easy and efficient administration of simulator users
• Online learning courses and video-based content
• . Proficiency based hands-on training.
• Performance reports with learning curve graphs.
• Recorded videos of the simulation sessions for debriefing.

5. HARVEY THE CARDIO PULMONARY PATIENT SIMULATOR:

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Harvey, the cardiopulmonary patient simulator CPS), can simulate the bedside findings
of almost any cardiac disease. This full-size manikin realistically simulates nearly any
cardiac disease at the touch of a button. Harvey is portable and may be used in any
environment in which a patient may be examined. Small groups with stethophones

SPECIFICATIONS:

 Cardiac Disease Cases (total 50)

 Standardized Patient Curriculum (total 10)

 Portable

 Breath Sound Areas (total 6)

 Cardiac Auscultation Areas (total 9)

 Digitally Driven Impulses (total 12)

 Modifiable Amplitudes and Intensities

CARDIAC DISEASE CASES:

Harvey provides a comprehensive curriculum by realistically simulating 50 conditions. It

is structured to start with common, less complex conditions and progress to more rare
and complex diseases.

1. Introductory Program

2. Normal (60 and 90 BPM)

3. Innocent Murmur (60 and 90 BPM)

4. Aortic Valve Sclerosis

5. Hypertension (60 and 90 BPM)

6. Angina Pectoris

7. Acute Inferior Myocardial Infarction

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8. Acute Anterior Myocardial Infarction

9. Ventricular Aneurysm

10. Mitral Valve Prolapse (MVP) (60 and 90 BPM)

11. MVP, Isolated Click and Murmur

12. Mitral Regurgitation, chronic

13. Mitral Regurgitation, mild (60 and 90 BPM)

14. Mitral Regurgitation, mild (variant)

15. Mitral Regurgitation, acute

16. Mitral Stenosis (MS) with severe Tricuspid Regurgitation (TR)

17. MS with mild TR (60 and 90 BPM)

18. Mitral Stenosis & Regurgitation

19. Aortic Regurgitation, chronic (60 and 90 BPM)

20. Aortic Regurgitation, acute

21. Aortic Stenosis (60 and 90 BPM)

22. Hypertrophic Obstructive Cardiomyopathy

23. Cardiomyopathy (60 and 90 BPM)

24. Acute Pericarditis (60 and 90 BPM)

25. Primary Pulmonary Hypertension

26. Atrial Septal Defect

27. Ventricular Septal Defect

28. Patent Ductus Arteriosus

29. Pulmonary Stenosis

30. Coarctation of the Aorta

31. Tetralogy of Fallot

32. Coronary Disease with Heart Failure

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 33. Mild Systolic Heart Failure

34. Mild Diastolic Heart Failure

35. Moderate Mitral Regurgitation

36. Moderate Aortic Stenosis

37. Mild Aortic Regurgitation

38. Aortic Stenosis and Regurgitation

39. Pulmonary Embolism

40. Cor Pulmonale

CARDIAC ASCULATION AREAS:

There are 9 auscultatory areas that are shown in the figure:
a. Aortic area (upper right sternal edge)
b. Pulmonary area (upper left sternal edge)
c. Tricuspid area (lower left sternal edge)
d. Mitral area (apex) e. Mitral radiation (posterolateral to apex)
f. Aortic or pulmonary radiation (upper chest)
g. Carotids

PULMONARY ASCULTATION AREAS:

The pulmonary auscultatory areas represented include the following lung fields:
a. right upper
b. right inferoposterior
c. right inferoanterior
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d. left upper
e. left inferoanterior
f. left inferoposterior

SOFTWARE:
PowerPoint® programs or linked to the UMedic Multimedia Computer Curriculum are
used to operate Harvey.
The self-assessment PowerPoint® programs that have been developed for each
disease state provide the history, physical findings, electrocardiograms, X rays,
echocardiograms, and hemodynamic, therapeutic, pathologic and epidemiologic
information. The slides sequentially guide the learner through each case and
conclude with a summary of the disease and a review of the case presented.
Harvey may also be interfaced with UMedic, allowing access to an advanced
interactive Multimedia Computer Curriculum. The entire patient evaluation is then
presented in real time.
6. BRONCH MENTOR:
This innovative portable simulator provides a meaningful yet affordable hands-on
solution to the growing demand for training and qualification for core bronchoscopy
skills and procedures. Bronch mentor provides a comprehensive solution for the
flexible bronchoscopy training needs of pulmonary and critical care physicians,
anesthesiologists and interventional pulmonologists. It provides a true-to-life training
environment using an authentic scope with tactile feedback, and realistic
visualization displayed on a 24” touch screen. A true-to-life training environment
using an authentic scope with tactile feedback, and realistic visualization displayed
on a 24” touch screen This innovative portable simulator provides a meaningful yet
affordable hands-on solution to the growing demand for training and qualification for
core bronchoscopy skills and procedures.

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 FEATURES AND BENEFITS:
• Realistic simulation featuring authentic scope, tactile feedback and a flexible
working setup promoting team training.
• True to life virtual patient cases modeled after real patients.
• Comprehensive patient environment includes sedation, topical anesthesia,
reactive vital signs, cough and complications.
• Unique educational environment enhances 3D perception, anatomical knowledge,
procedural know-how and patient safety.
• Training and assessment are designed to foster safe and efficient performance
while considering patient safety, procedural adequacy, clinical discretion,
diagnostic yield and equipment safety.
• Meaningful performance metrics for self-assessment and competence
demonstration prior to real patient practice.

8.LAP SIM:
Lap sim is the laparoscopy simulator. LapSim ® is also the only VR system that offers a
fully customizable curriculum, allowing for a diversity of unique challenges, and
increasing levels of difficulty.

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 BASIC SKILLS MODULE:
The LapSim® Basic Skills module offers a comprehensive portfolio of laparoscopic
procedure exercises that range from basic navigation to advanced suturing. Each
exercise is customizable to provide complications and ongoing challenges. Basic Skills
module includes 13 exercises:
– Camera Navigation – Instrument Navigation
– Coordination – Suturing
– Grasping – Cutting
– Catheter Insertion – Clip Applying
TASK TRAINING:
Inspired by the Fundamentals of Laparoscopic Surgery (FLS), a standard developed by
the Society of American Gastrointestinal Endoscopic Surgeons (SAGES).
The Task Training module includes:
 Wireloop (included in LapSim 2018)
 Peg Transfer
 Pattern Cutting
 Ligating Loop
LapSim® Haptic System
The advanced force feedback technology combined with the powerful graphics and
cognitive instruction of the LapSim® gives you an immersive, multi-sensory training
experience. The technology is placed on an ergonomically designed platform, that allows
navigation on two touch screens and features the latest in tactile feedback technology.

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9.SONOSIM:
Sonosim is the ultrasound training simulator. It is the most comprehensive yet easy-to-
use ultrasound training solution available. The laptop computer-based platform provides
you the freedom to learn anytime-anywhere. The SonoSim Ultrasound Training Solution
provides extensive didactic teaching, hands-on training, and knowledge assessment on a
variety of topics. SonoSim features over 1,000 actual patient cases with real pathologies
for an unparalleled hands-on ultrasound training experience.

Sono Simulator Features:

1. Vast library of real patient SonoSim® Cases.
The Case List button provides immediate access to a wide-ranging and ever-growing
SonoSim® Case Library.
2. Easy case to case navigation.
The Case Navigation feature allows users to navigate forward or backward to the next
hands-on training case by selecting the arrow icons on the Case button.
3. Integrate patient history and physical findings into clinical decision making.
The Case History feature provides a brief patient history including information such as
age, gender, vital signs, and chief complaint.
4. Body positioning.
The Body Position feature allows users to place the virtual patient in different positions
that provide alternative viewer perspectives.

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 5. Visualize how the ultrasound beam array transects through the underlying
anatomy.
With the Layers feature, anatomic layers can be removed to reveal underlying anatomy,
allowing the user to correlate the ultrasound image to relevant anatomic structures
6. Optimal ultrasound window guidance.
Probe-positioning guidance assists users in orienting the probe in the optimal imaging
plane.

7. Virtual human body.

A three-dimensional human body model depicts dynamic anatomic structures. Adult &
pediatric and male & female bodies are displayed as are appropriate.

8. Doppler imaging.
The Doppler button enables learners to examine motion detection and blood flow
characteristics through a variety of imaging modalities, including m-mode and power,
color-flow, and pulsed-wave Doppler.
9. Multimedia window.
The Split Screen feature enables users to easily compare ultrasound findings and image
characteristics with those provided by other imaging modalities (e.g., plain radiographs,
CT, or MRI).
10. Learn how to move the transducer and localize a target vessel.
Users learn how to move an ultrasound transducer and localize a target vessel in short-
axis and long-axis views.

10.DENTAL SIMULATORS:
Dental simulators provide the most comprehensive and integrated solution in the field of
dental education. The Phantom-head Dental Simulators enables the students to learn
with a high level of clinical relevance in a controlled setting. Students get to experience a
complete delivery system that combines operability of air-turbine and electric hand
pieces, ultrasonic instruments, curing lights, and cameras while practicing procedures
over a movable manikin.

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11.VIMEDIX “ULTRASOUND SIMULATOR”:
The Vimedix ultrasound simulator is a high-fidelity ultrasound simulator designed to
make learning more engaging and intuitive. Vimedix is an innovative ultrasound training
platform that makes it easier and faster to learn cardiac, lung and abdominal ultrasound.
Our manikin-based simulator allows healthcare professionals to learn the psychomotor
and cognitive skills needed for ultrasound scans. Freed from its two-dimensional
environment inside a monitor, our Vimedix ultrasound simulator leaps to life, displaying
anatomy you can enlarge, turn, rotate or command to return into its manikin body so you
can view the interrelatedness of all of its structures.

12.EYESI SURGICAL SIMULATOR:

Eyesi Surgical is a high-fidelity virtual reality simulator for intraocular surgery training.
The highly realistic simulation of cataract and vitreoretinal procedures increases the
residents’ surgical experience without the risk of complications for patients. Residents
can practice on their own or under guidance from a mentor. With Eyesi Surgical, realistic
and reproducible training is available at any time – independent of the patient flow.

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13.VITRAMED:
VITRAMED is a simulator related to urology. VirtaMed provides simulation training for
TURP, TURB, laser BPH with Thulium or HoLEP, and morcellation. During the training,
students learn how to master instruments and manage complications without involving
live patients.

FEATURES OF VITRAMED:
Highest realism
1. Photorealistic graphics
2. Bleedings & complications
3. Robot for best in class tactile sensation
Customized training:
1. Endless variety of different training cases and pathologies available
2. SimProctoR for guidance
3. Live performance feedback and expert-defined scoring

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 Swiss engineering:
1. Movable display cart with height-adjustable screen.
2. Easy transportation.
3. 23‘‘multi touch monitor.

Urology training modules:

TURP basic skills 8 training cases introduce beginners to trans-urethral surgery. The basic
skills module breaks down and teaches the steps of TURP before attempting the full
procedure. The module contains different basic tasks, including visualization of important
landmarks such as verumontanum or ureteral orifices, bleeding control, and partial
resection of either the median lobe or the side lobes.

TURP full procedures:

8 training cases offer patients with varying prostate sizes for complete transurethral
resection of the prostate (TURP). The full TURP cases allow trainees to get familiar with
each step of complete procedures using an original active or passive resectoscope.

TURB:
4 virtual patients with different, multiple papillary and solid bladder tumors offer
trainees the opportunity to perform complete TURB procedures in a safe environment
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without involving patient-related risk. The level of difficulty of the cases differs in the
type of the bladder tumors, their location and the intensity of the complications, such as
bleedings and risk of perforating the thin bladder wall.

Laser BPH:
8 training cases for partial and full procedures with ThuLEP or HoLEP laser teach
surgeons the removal of prostatic tissue with different endoscopic laser techniques:
vaporization, enucleation, and vaporesection.

14.VOXEL-MAN:
Voxel-men is a ENT surgery simulator. It combines the modules Tempo for temporal bone
drilling, Sinus for endoscopic sinus surgery and My Cases for working with your own data
from CT. Based on virtual reality and robotics, it provides a look and feel close to the real
intervention. Voxel-Man ENT is ideally suited to gain a thorough understanding of the
surgical anatomy and approaches in a safe environment.

 VOXEL -MAN TEMPO:

Voxel-Man Tempo is a training simulator for surgical access to the complex and
vulnerable structures of the middle ear. Patient and instruments are modeled in high
resolution inside a computer and visualized on a 3D screen. The handpiece is
represented by a force feedback device. With our patented haptic rendering, it provides
a highly realistic tactile feedback. Surgical instruments include a selection of metal and
diamond burs of different sizes, which are activated by a foot pedal. A suction allows for
two-handed training. A virtual surgical navigation system is permanently tracking the
movements of the instruments.

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 Voxel-Man Sinus is a simulator for training of endoscopic sinus surgery. It allows for
simultaneous handling of the endoscope and a surgical instrument, and is
especially suitable for training of orientation based on endoscopic images.

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