Explor-A-Thora: A Novel Three-Dimensionally Printed Pleural Simulator.

Background: For procedural education, the shift from the traditional apprenticeship model to simulation-based mastery has become increasingly accepted as the gold standard and has underscored the importance of high-fidelity, cost-effective training options. However, cost-effective pleural procedure simulators providing both realistic haptic feedback and ultrasound compatibility are lacking. Objective: We aimed to create a pleural procedure simulator with characteristics of human tissue, at low cost and with ultrasound compatibility. Methods: This work used design-based research principles and a collaborative rapid iteration approach in collaboration with the University of California, San Francisco, Makers Lab and design-based researchers at the University of California, Berkeley, which led to the creation of a three-dimensionally printed pleural procedure simulator. Results: The needs assessment indicated significant discomfort with pleural procedures and a request for more accessible simulation opportunities. Iterative prototyping resulted in a three-dimensionally printed rib cage and a series of innovations in the fluid pocket and skin layers to provide realistic tactile feedback and ultrasound imaging compatibility. The final model costs significantly less than commercial simulators, with durable components and replaceable parts that can be reused multiple times. Conclusion: The development of a low-cost, high-fidelity pleural procedure simulator addresses the current limitations of commercially available pleural simulators. By integrating three-dimensional printing technology and easily accessible materials, we were able to produce a simulator that closely replicates the feel of human tissue, allows ultrasound use, and is adaptable for different patient anatomies and clinical scenarios. This novel simulator is a scalable solution to elevate the standard of procedural education and ultimately positively affect patient care.