Intelligent Ultrasound Works with Pleural Disease Experts to Increase Respiratory Training Opportunities and Patient Safety

2nd August 2023, Cardiff, UK: Intelligent Ultrasound (IU) has worked with pleural disease experts to increase respiratory training opportunities and in turn patient safety. The nine new types of pathology, due for release on BodyWorks Eve in September, will provide trainees with a structured approach to learning and access to different pathologies ‘on demand’.

Dr Andrew Stanton and Dr Duneesha de Fonseka, consultant respiratory physicians, with specific expertise in pleural disease have provided expert advice and guidance for this new initiative.  Both have been closely involved in British Thoracic Society Training Standards and Guidelines in this area.  The BTS Training Standards for Thoracic Ultrasound1 (TUS) recognize the role simulation can play to support ultrasound training for clinicians in the UK.

Dr Martin Allen, consultant physician and National Specialty Advisor for Physiological Science, was instrumental in driving this work to improve simulation training, following the investment in BodyWorks Eve systems by Health Education England to support training in echocardiography and pleural ultrasound.

Dr Allen introduced Andrew and Duneesha to IU to understand whether additional pathologies could be developed and added to Eve to support the BTS TUS training requirements. In line with the company’s vision to make ultrasound accessible to all medical professionals, a new project began.

Prior to using simulators, pleural safety training was delivered using models and via teaching sessions on how to perform procedures. Specific ultrasound courses were run in addition to this with patients, otherwise it was bedside training on a one-to-one basis. Like many departments, the pandemic reduced experiential learning opportunities, which impacted workforce development.

Andrew commented “It’s a big area and ultrasound and pleural procedural safety has been high on the agenda for a number of years, ever since the National Patient Safety Alert now 15 years ago.”

As part of the project kick off, Dr Allen and the team looked at the existing content on BodyWorks Eve and then sent a ‘wish list’ of additional pathologies which would support and further enhance pleural safety training. These pathologies related primarily to the learning objectives for trainees looking to become ‘Primary Thoracic Ultrasound Operators’. Priority pathologies and timelines for development were agreed, monthly review meetings ensured everything was on track and in line with BTS training standards.

The result, nine new types of pathology (up to eighteen if you consider varying severity and location) including empyema, diaphragmatic nodules and septated pleural effusion.

Duneesha commented “IU has produced a brilliant simulation program that will provide trainees with the opportunity to build up their initial foundation skills, but also provide a platform they can return to to refresh their skills. When respiratory trainees begin, they need to be familiar with the basics, which may not be available to see when learning at the bedside. Using simulation, they have a structured approach to learn more common procedures such as pleural effusion to more complex things such as pleural nodules. They can do this in one sitting, in their own time, it’s a fantastic resource for trainees.”

Andrew continued “The variety of pathologies in the new simulation package is excellent. It’s sometimes hard for trainees to see these on demand at the bedside. Having the pathologies available to review and discuss in a safe, simulated environment, along with potential clinical issues, how to manage these and the approach to pleural intervention on account of the findings is invaluable. The images, reflecting on what we see in real life, are very high quality. Clinical colleagues, who saw these as part of the preparatory work, were very impressed. I’m confident this is going to be very well received by the respiratory community to support training”.

The new pathologies will be launched as part of the BodyWorks Eve 4.5 release in September 2023.

Andrew commented “Within the BTS Training Standard, there’s a move to create different levels of operator competence and to facilitate safe ultrasound delivery, and in turn pleural intervention. The new pathologies on BodyWorks Eve will help to build up a pool of ultrasound operators and help respiratory trainees specifically to develop skills beyond basic ultrasound. It’s widening the training opportunities afforded to both regions and trusts.”

Research and Development Manager at IU, Kathryn Jenner commented “This project has not only expanded Eve’s pathologies but has allowed us to use new methodologies in development, further improving the quality of our patient images, while further expanding Eve’s capabilities as PoCUS use continues to grow across hospital departments.”

The new pathologies on BodyWorks Eve 4.5 are just the first initiative. A list of additional respiratory pathologies is in place and will hopefully be developed and released as part of future versions of the female manikin.

References: 1 British Thoracic Society Training Standards for Thoracic Ultrasound (TUS) (

BodyWorks is a hi-fidelity simulator for Point-of-Care ultrasound (PoCUS) used in critical care, intensive care and emergency medicine.