Simulated Cranial Ultrasound for Longitudinal Learning (SCULL): A Simulated Task Trainer for Emergency Medicine...

Although point-of-care ultrasound (POCUS) is a useful imaging modality for evaluating suspected pediatric skull fractures, emergency medicine (EM) residents have limited opportunities to develop proficiency because these injuries are encountered infrequently during clinical training. To address this educational gap, we developed a low-cost, reproducible, and durable simulated pediatric skull model designed to replicate both intact and fractured cranial anatomy. The model was constructed from two inexpensive educational skull replicas and ballistic gel, with one skull manually fractured and reassembled using adhesive. Both skulls were coated with layers of ballistic gel to simulate scalp tissue. The total production cost was less than $200. The model was piloted in a small-group training session involving 14 EM residents. Participants received a didactic overview and then engaged in hands-on practice using ultrasound to assess both intact and fractured models. Survey data demonstrated strong educational value: 100% of learners found the session educational, 86% reported improved confidence in identifying cortical irregularities, and 93% expressed an intention to apply POCUS for skull fracture assessment in future practice.