The Zipperator! A Novel Model to Simulate Penile Zipper Entrapment.

Area of Science:

• Medical Education
• Pediatric Emergency Medicine
• Clinical Skills Training

Background:

• Penile zipper entrapment is an uncommon but common cause of genital injury in young boys, often causing significant patient and provider anxiety.
• Existing methods for release vary, and a lack of practice opportunities exists due to the low frequency of this chief complaint.
• A well-designed simulation model can provide a controlled environment for practicing various release techniques and improving learner confidence.

Purpose of the Study:

• To develop and evaluate a novel, low-cost simulation model, the "Zipperator," for training emergency medicine resident physicians on penile zipper entrapment release.
• To assess the impact of the Zipperator training model on resident confidence and comfort in managing penile zipper entrapment cases.
• To provide a reproducible and accessible training tool for a rare, high-anxiety clinical scenario.

Main Methods:

• A low-cost simulation model, the "Zipperator," was constructed using a household gameboard ("Operation") and common emergency department supplies.
• The model was integrated into a voluntary Emergency Medicine curriculum, with 60 resident physicians participating over two years.
• Learners completed pre- and post-training surveys to evaluate their comfort levels, experience, and the model's educational value.

Main Results:

• Prior to training, 68.3% of learners felt very uncomfortable or totally uncomfortable managing zipper entrapments.
• After training with the Zipperator, 71.7% of learners reported feeling comfortable to very comfortable managing future cases.
• Learners with prior experience treating zipper entrapments found the model reflective of real patient encounters.

Conclusions:

• The Zipperator is an inexpensive, easily replicable simulation model that effectively increases resident physician confidence in managing penile zipper entrapments.
• This novel training tool addresses the challenge of low-volume, high-anxiety presentations in emergency medicine.
• The simulation successfully familiarized learners with the procedural steps and psychological aspects of managing zipper entrapment.