Teaching Emergency Surgical Skills for Trauma Resuscitation-Mechanical Simulator versus Animal Model

Table 6

Summary of comments by participants.

Advantages	Disadvantages
Porcine model
(i) More realistic feel and handling	(i) Ethical concerns—having to sacrifice the animal
(ii) More surgically realistic	(ii) Cannot repeatedly practice on the same animal
(iii) Real-time live animal	(iii) Cricothyroidotomy can only be done once
(iv) Moving tissues	(iv) Expensive
(v) Anatomic detail is good—representation of the layers of body wall	(v) Airway anatomy is not similar to human
(vi) Likely cheaper
(vii) Presence of blood in operative procedure field
(viii) Presence of active monitoring more like trauma bay
(ix) Psychological factor of practicing on a living animal
TraumaMan model
(i) Ethical advantage—no animal use	(i) Not real feel of human tissue
(ii) Procedures can be repeated many times	(ii) Not real feel to chest wall
(iii) Cost advantage versus animal	(iii) Cost of trauma man
(iv) Consistent anatomy	(iv) Bloodless field
(v) Easy to learn and practice	(v) Cricothyroidotomy space is larger than reality
(vi) Easy to teach	(vi) Tissues more brittle than human—chest wall is easy to enter
(vii) Always available for practice	(vii) Rubber poorly simulates skin
(viii) Good to learn landmarks—similar to human anatomy	(viii) Needs better simulation of underlying tissue layers
(ix) Less smelly
(x) Reproducible technique
(xi) Opportunity for all participants to try all procedures
(xii) Portability—can be transported to another hospital
(xiii) No need for special animal laboratory space
(xiv) Reusable

Additional Comments
(i) Combined tissue/synthetic model may be more preferable.
(ii) Cricothyroidotomy needs a more elaborate anatomical kit with more details.
(iii) Chest wall is easy to enter. It may benefit from more thickness or layers in the TraumaMan model.
(iv) Unrealistic feel is less important to teaching compared to ethical dilemmas with animal use.