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Low-Cost, Objective Trainers Seek to Boost Surgical Skills


At first glance, a new surgical skills trainer conceived at the University of Minnesota works a lot like the classic game Operation. The user musters fine motor skills to loop a tiny ring around a wavy metal rod without letting the two touch. Unlike the buzzing, battery-powered children’s game, however, the trainer has a greater purpose: to better prepare surgeons for the operating room.

Medjules – medical trainers with interchangeable skill modules – are innovative low-cost devices that teach key surgical skills and provide objective feedback. Trainees can determine their proficiency without the need for a proctor to watch. Basic feedback shows through indicator lights on the device, while a more comprehensive readout can be read once connected to a computer.

The idea behind Medjules started as a class project in the U’s New Product Design and Business Development program, assisted by Dr. Rob Sweet, director of the U’s center for simulation equipment and clinic training, SimPORTAL. Medical student Alex Doud’s group enlisted the help of the U’s Office for Technology Commercialization toward the end of the semester.

“We all had a feeling we were onto something worth pushing forward,” Alex said. “The folks at OTC were extremely supportive of this process and gave us a lot of what we needed to get started making this prototype into a reality.”

Medjules, one of 14 start-ups OTC launched last fiscal year, came to be right around the time Alex and his wife Natalie Doud’s interactive design studio, Synaptic Design, was growing in Minneapolis. The two firms joined forces.

Interest in the trainers wasn’t contained to the U. During a medical school rotation working at the Mulago National Referral Hospital in Kampala, Uganda, Alex kept an eye out for ways to implement Medjules and improve their design. A chance meeting with one of the senior surgeons there revealed a new simulation lab for laparoscopic training was set to open in Mulago. Alex and the surgeon arranged for the trainer to be field tested at the hospital. A better grasp of less invasive operations would reduce the number of open surgeries at Mulago, meaning fewer patients would suffer complications like infection.

“Medjules are an attractive tool for them to be able to work toward those skills,” said Natalie, who is working with electrical engineering student Emal Alwis to design the look and feel of Medjules, both in terms of hardware and software.

The tool articulation module, now being tested in the field, determines whether the user has the dexterity to operate laparoscopic instruments. Two others are now in the prototype stage: a suturing module to teach the intricacies of skin closure and a surgical knot-tying module to evaluate the strength and integrity of each knot. As Medjules become more widely available, Alex hopes to see the platform expand to fit new needs and become a recognized name in evidence-based medical training. The devices will drive training forward in a broad spectrum of clinical scenarios and cultural contexts.

“The impact of this technology goes beyond the teaching of a single skill,” Alex said. “We are creating a platform where many skills can be swapped out and developed over time.”

Two teaching labs, one at the U of M and one in Kampala, are now in the works. Medjules has also begun to integrate with Moodle, a course management system many university classes use, and its surgical trainers will soon be a part of the medical school’s curriculum. Professor Tim Kowalewski of the College of Science and Engineering, the mechanical engineering adviser for the Medjules project, said surgical trainers give students important experience.

“People learn by making mistakes; that’s a fact,” Kowalewski said. “With simulation, surgeons can make mistakes and hone their skills before they get to patients. Alex’s strategy is to create modules that are inexpensive enough to be bought by hoards of individual students in medical, nursing and veterinary schools.”

Alex is looking to the future with Medjules. He hopes to reach out to and collaborate with those who have already established robust training systems and push their collective design abilities to the limit.

“I hope to come out with the best possible system that will meet students’ needs,” he said.

Originally published on Business @ the U of M.

Kevin Coss

Kevin Coss

Kevin is a writer with the Office of the Vice President for Research.

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