TissueDB/Simulators/Cervical Cancer Screening Simulator

This simulator allows nurses, midwives, clinical officers, and medical officers to become confident and competent in performing visual inspection with acetic acid (VIA) as part of cervical cancer screening procedures performed in primary health care facilities and mobile units in resource-constrained settings. It contains five components: (1) base, (2) support pillars, (3) angled plane with triangular supports, (4) vaginal canal with augmented feedback, and (5) interchangeable cervix models representing nulliparous and parous anatomy.

The aluminium-foil lining of the vaginal canal is the conductive surface for the augmented-feedback circuit of the companion Thermal Ablation Simulator, which alerts the learner if a heated probe contacts the vaginal sidewalls during thermal-ablation training.

Step 1: Cut a cardboard base 19.0 cm × 16.5 cm. Cut two 5.0 cm long central slots, 4.5 cm apart and 3.0 cm from the bottom edge, to receive the support pillars.

Step 2: Cut a cardboard angled plane 13.0 cm × 16.5 cm. Cut a 0.5 cm wide horizontal slit centrally, 5.5 cm from the bottom edge, to receive a tongue-depressor piece for cervix mounting.

Step 3: Cut two right-triangle cardboard pieces 9.0 cm × 9.0 cm. Cut a 1.5 cm wide horizontal slot in each, 1.5 cm from the side and 2.0 cm from the bottom, for tongue-depressor reinforcement.

Step 4: Cut two cardboard rectangles 13.0 cm × 3.0 cm to form the support pillars. In each pillar cut two vertical slots 1.5 cm wide — a lower slot 2.5 cm from the bottom and an upper slot 7.5 cm from the bottom — to receive tongue-depressor crossbeams.

Step 5: Tape the triangular supports to the base, then attach the angled plane to the base and to the triangular supports. Insert one whole tongue depressor through the slot in each triangular support and tape the two together in the middle to strengthen the supports.

Step 6: Insert one support pillar into each base slot. Insert a half tongue depressor horizontally into the lower slots of both pillars, then another into the upper slots, to lock the pillars in place. Insert a 0.5 cm tongue-depressor piece into the central slit of the angled plane, underneath the two taped tongue depressors behind the plane — this piece holds the cervix model. Check the structure is stable.

Step 1: Cut a paper rectangle 13.0 cm × 14.0 cm — sized to the upper range of vaginal length plus cervix length.^[1][2] Mark a 3.0 cm strip along the top edge that will not be lined with foil; this end sits adjacent to the cervix model.

Step 2: Cut a strip of aluminium foil extending 1.0 cm beyond the paper edge for folding. The foil lines the inside of the canal and conducts the augmented-feedback signal.

Step 3: Tape the area of the paper that will be lined, then press the foil onto the taped area. Important: do not tape over the foil itself — tape over foil insulates the conductive material and stops the augmented-feedback circuit working.

Step 4: Fold the 1.0 cm foil overhang around the paper edge. Roll the paper into a 4.5 cm diameter cylinder (14.0 cm circumference) with the foil lining the inside.

Step 5: Tape the outside of the cylinder closed, leaving a section of folded foil exposed (untaped) for the alligator-clip connection. Check with a ruler that the diameter is 4.5 cm.

Step 1: Roll pink water-based clay (for example, Play-Doh) into a cylinder 2.5 cm in diameter and 3.0 cm long, matching the published nulliparous cervix dimensions (25.51 mm width × 29.18 mm length).^[2]

Step 2: Press a pencil tip into the centre of the cylinder to simulate the smooth, rounded os of a nulliparous cervix.^[3]

Step 3: Add red clay to the cervix face to simulate the columnar epithelium of the endocervix and define the squamocolumnar junction as a sharp, visible border near the external os.

Step 4: Add white clay next to the squamocolumnar junction to simulate a clinically significant acetowhite lesion — distinct, opaque, with well-defined margins, in the transformation zone close to the os.^[4]

Step 5: Mount the cervix model on the angled plane, stabilising the tongue-depressor piece behind the plane. Place the vaginal canal over the cervix with the non-foil end adjacent to the cervix and the foil-lined end resting on the upper-slot tongue depressor between the support pillars. Connect the red alligator clip of the augmented-feedback circuit to the exposed foil.

Step 1: Roll pink water-based clay into a larger cylinder 3.0 cm in diameter and 3.0 cm long, matching the published parous cervix dimensions (28.18 mm width × 31.89 mm length).^[2]

Step 2: Use a pencil tip to create the wider "fish mouth" os of a parous cervix.^[3]

Step 3: Add red clay to define the squamocolumnar junction; the transformation zone may be larger in parous anatomy.

Step 4: Add white clay adjacent to the squamocolumnar junction to simulate an acetowhite lesion.^[4] Interchange the nulliparous and parous models to train recognition of anatomical variation.

Step 5: Mount the parous cervix model on the angled plane and place the vaginal canal over it as in Phase 3 Step 5. Connect the augmented-feedback circuit.

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