Modification of an abdominal diagnosis teaching simulator to reproduce patterns of resistance to pressure

Aim Within the Kampo medical system, there exists a system specific to Japan of abdominal diagnosis called abdominal palpation, or Fukushin, which is used to obtain a holistic picture, called an abdominal pattern, of the physical indications in the abdominal area. In order to educate students in this system, we have devised and continued to develop a Fukushin simulator, incorporating various improvements as appropriate. The present study describes some recent additions to the model with the aim of increasing its applicability across a broad range of abdominal patterns. Methods The simulator is modeled on the abdomen of a healthy adult man, from which we took a mold using flexible silicon resin. To increase the resistance in some areas, we used urethane foam mixed with silicon rubber or attached parts consisting of silicon rubber; to reduce the resistance to pressure in other areas, we used urethane foam in small quantities. Results By such adjustments, we were able to reproduce patterns seen frequently in abdominal palpation, that is, stuffiness and rigidity below the heart, rectus muscle tension, fullness in the chest and hypochondrium, and lower abdominal fullness, each marked by localized increases in resistance to touch; and lower abdominal numbness, marked by a localized reduction in resistance to touch. Conclusion It is expected that the simulator will make an important contribution not only to medical education but also to the standardization of abdominal diagnosis.