Wake Forest Baptist Physician, Wake Forest Innovations and Forsyth Tech Combine Skills and Expertise to Produce New Medical Training Device

Joshua Nitsche, MD, PhD demonstrating the ultrasound-guided invasive procedure trainer

Postgraduate fellows in maternal-fetal medicine at Wake Forest Baptist Medical Center are now practicing invasive procedures on a training device invented by a Wake Forest Baptist physician and designed and built by Forsyth Technical Community College students in collaboration with Wake Forest Innovations.

While the patent-pending device, an ultrasound-guided invasive procedure trainer, was conceived for use in maternal-fetal medicine – the subspecialty of obstetrics and gynecology devoted to assessing and managing high-risk pregnancies – it has adjustable features that make it suitable for training in other fields that employ ultrasound-guided procedures.

“The device provides a risk-free way to develop the hand-eye coordination and other skills needed to perform amniocentesis and other delicate procedures on a patient,” said the trainer’s inventor, Joshua Nitsche, M.D., Ph.D., assistant professor of maternal-fetal medicine at Wake Forest Baptist. “Everybody has to do something for the first time, but this can help clinicians gain competence, experience and confidence before that first time.”

Nitsche was dissatisfied with the available invasive-procedure training devices, which simulate specific anatomic structures and procedures, so he decided to make one with wider utility. He did, using materials from a home improvement store, then took his creation to Wake Forest Innovations, the Medical Center’s commercialization arm. There, Kenneth Russell, director of product innovation services, and Mohammad Albanna, an innovation associate, recognized its potential as a commercial product and the need for a prototype more sophisticated than Nitsche’s homemade model.

As Wake Forest Innovations doesn’t have production facilities, Russell and Albanna contacted Todd Bishop, coordinator of the mechanical engineering technology program at Forsyth Tech, and David Dinkins, an instructor in the program. They agreed to take on the project for two classes.

“We like to have students work on as many ‘real-world’ projects as possible and this seemed like a great opportunity,” Dinkins said.

Starting in the fall, seven Forsyth Tech students – three in mechanical engineering technology, four in computer-integrated machining – worked on the design, composition and construction of the device in consultation with Nitsche, Russell and Albanna. By February, they had produced three professional-quality ultrasound-guided invasive procedure trainers.

Training Device Collaborators: Joshua Nitsche, MD, PhD; Kenneth Russell and Mohammad Albanna, Wake Forest Innovations; David Dinkins and Students, Forsyth Tech

Nitsche took the Forsyth Tech-made prototypes to the annual meeting of the Society of Maternal-Fetal Medicine, where they received favorable reviews, and began using them in his teaching sessions with postgraduate fellows.

The training device consists of a plastic basin with a side valve, a removable cover of either silicone or ballistic gelatin (to simulate human skin), an aluminum ring, steel draw latches and targeting constructs of various sizes and shapes with anchoring magnets.

Here’s how the device is used: A targeting construct is placed at the bottom of the basin then the basin is filled with water. The soft cover is placed over the basin, held in place by the aluminum ring and secured by the steel latches. More water is added to the basin through the valve until the cover develops a curvature (to simulate an abdomen). After sonographic gel is applied, the user places an ultrasound transducer on the cover with one hand and inserts a needle with the other. Using the ultrasound image as a guide, he or she attempts to direct the needle to the targets.

The changeable, moveable targets are what differentiate this device from other trainers.

“It can be made more or less challenging, which is a rare feature in medical simulators,” Nitsche said. “And it can mimic different patient situations for different procedures.”

The ultrasound needle guide trainer is currently available for licensing through Wake Forest Innovations.

“Working with Wake Forest Innovations and seeing how something goes from an idea to a real product was interesting and informative,” Nitsche said. “And working with the students and instructors at Forsyth Tech – exchanging ideas, learning about materials and so on – was great.”

“This was a valuable educational experience for the students,” Dinkins said. “By interacting with professionals to develop an actual product they learned lessons beyond what they would normally get in the classroom. We anticipate this will be a jumping-off point for more collaboration with Wake Forest Innovations.”

Photos courtesy of Forsyth Tech