To date, the total number of confirmed COVID-19 cases around the world is nearly 209 million, according to the World Health Organization. I can’t even begin to work out the math on how many COVID-19 nasal swab tests have been administered to diagnose the virus, but I think it’s safe to say that the number is fairly large. The making, and testing, of 3D printed nasopharyngeal (NP) swabs over the past year and a half has not only shown just how scalable 3D printing can be, but also helped meet the supply for a medical item that’s been in fairly high demand. As we all continue learning to live with COVID-19 in the world, it makes sense that we’ll need to start quickly training non-medical personnel in proper swabbing technique, and Singapore-based Q & M Dental Group has been working with 3D printing hub Creatz3D, also in Singapore, to come up with a solution—a 3D printed medical mannequin.
“Our focus was to find models with a cross-sectional view of the nose area, so that we could teach learners about specific anatomical landmarks and what to watch out for while swabbing,” explained Joseph Lua, an associate at Q & M Dental Group. “We wanted a model that could let us explain procedures effortlessly to a non-medical trained person.”
Q & M wanted to complement its COVID-19 swab training curriculum, and through their research discovered the 3D printed medical mannequins that Creatz3D developed last summer for a front-line training organization, together with its subsidiary AuMed, which creates bespoke medical simulators. These teaching mannequins were more beneficial than others Q & M found while searching, as they feature notable anatomical features and are actually life-sized.
As AuMed explains, a swabbing procedure is used to collect clinical test samples from the back of the nose and throat by inserting a swab into the person’s nostril. In Singapore, training for swab collection is provided to health professionals who have voluntarily taken time off to help, but also to selected civilians who typically don’t have any medical knowledge or training. So it’s important that a tactile training tool is used, and the 3D printed Creatz3D/AuMed mannequin certainly fits the bill.
Featuring a cross-sectional view so trainees can easily see the craniofacial anatomy while practicing with a test swab, the mannequin was 3D printed using four different materials, out of four different colors, in order to make a distinction between the soft tissues and offer tactile feedback. AuMed didn’t have any CT or MRI DICOM data to create the original mannequin design, but instead fused together different anatomical 3D models from its own library to create the training head, which took only five days of CAD designing, 3D printing, and post-processing to produce.
In April of 2020, Q & M, which is the largest private dental healthcare group in Singapore, was one of the first to switch out dental probes for nasal swabs. To help with the country’s COVID-19 detection, over 120 of its dentists and staff subsequently administered nasal swabs to people at hotels, foreign worker dormitories, and government quarantine facilities.
Q & M obviously gained a lot of experience with nasal swabbing, and as such had important insights to share in order to improve the efficiency, standardization, and safety of the swabbing workflow; in fact, the Health Promotion Board (HPB) actually incorporated some of the dental group’s suggestions as part of its standard protocols when training non-medical personnel in the art of nasal swabbing. After its initial hands-on training with the Creatz3D and AuMed 3D printed mannequin, Q & M wanted to personalize it even more to help trainees gain a better understanding of swabbing procedures, like anterior nares swab and oropharyngeal mid-turbinate swab, in addition to just the traditional NP swab.
“It has been great working with Creatz3D,” Lua said. “We provided information regarding our specifications and our requirements were quickly acknowledged by the sales team. They were highly responsive whenever we had questions, and there was no beating around the bush.”
The subsequent iterations of the mannequin helped improve the trainees’ overall learning experience. They were able to better understand the structure of the nose and nasal cavity, and learn the resistance points they might encounter when performing a swab. Additionally, because the 3D printed mannequin is life-sized, the trainees had enough depth to practice and attain a good swabbing technique, and post-training, they were confident enough to perform various infection prevention and control procedures in addition to swabbing.
To help meet the demand for COVID-19 screening and detection swabbers in Singapore, Q &M is now offering a COVID-19 Swabbing Proficiency Course for non-medical professionals through its College of Dentistry. Led by experienced medical professionals and supplemented by the 3D printed mannequin, the course—which is currently pending SkillsFuture accreditation—will teach all swabbing techniques and swab site workflow and operations, as well as how to perform special tests like Antigen Rapid Tests and Antibody serology tests.
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