Development of foetal and neonatal simulators at the University of Porto

Background Human error can be expected to play a significant role in adverse outcomes in perinatal acute care. In acute care of the adult, simulator based training is recommended and used to improve patient safety. Aims Our general goal is to develop model-driven foetal and neonatal educational simulators and curricula. The specific objectives of this paper are to introduce the reader to the perinatal acute care context and simulator design considerations, as well as to give initial results and describe ongoing developments. A brief description of adult simulators and simulation engines is followed by a more detailed description of a foetal distress simulator (FDS) and of models for a neonatal simulator developed at the University of Porto. Ongoing developments involve the modelling of foetal baroreflexes, the effect of uterine contractions, and an adapted method for estimating foetal heart rate variability parameters. Results We present FDS simulation results reflecting the changes in oxygen supply to the foetus and the foetal heart rate in response to a reduction in uterine blood flow. We also present a structural diagram of a model for the educational simulation of congenital heart disease and preliminary simulation results reflecting a patent ductus arteriosus. Conclusion We expect that, after initial clinical and educational validation, the presented models and simulators will play a role in simulator-based educational programmes contributing to increased perinatal safety.