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World J Emerg Surg. 2019 Jan 8;14:1. doi: 10.1186/s13017-018-0220-3. eCollection 2019.

Kunafa knife and play dough is an efficient and cheap simulator to teach diagnostic Point-of-Care Ultrasound (POCUS).

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1Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, 17666 United Arab Emirates.
2Department of Internal Medicine, College of Medicine and Health Sciences, UAE University, Al-Ain, 17666 United Arab Emirates.



Point-of-Care Ultrasound (POCUS) is a useful diagnostic tool. Nevertheless, it needs proper training to reach its required level of competency. Educators who work in low-income countries find it difficult to purchase expensive training computer-based simulators. We aim in this communication to describe the methods to build up and use an efficient, simple, and cheap simulator which can be used for teaching POCUS globally.


It took our group 2 years to develop the simulator to its current form. The required material for the simulator includes a Kunafa knife, a carton gift box and its cover and colored play dough. The Kunafa knife with its blade is an excellent simulator for the small print convex array probe (3-5 MHz) and its ultrasound sections. It is useful to teach two important principles. First, the three basic hand movements used to control the ultrasound probe (fanning, tilting, and shifting). Second, the thin blade of the knife (1 mm thick) simulates the shape of the two-dimensional ultrasound images. The play dough is used to simulate different organs to be cut in different directions like the aorta and inferior vena cava.


The simulator was used to teach 88 fifth year medical students during the period of November 2017 to November 2018 at the College of Medicine and Health Sciences, UAE University. The simulator was valid, simple, portable, and sustainable. The students greatly enjoyed its use. The cost of the simulator is less than 10 US dollars.


Surgical educators who work in low-income countries are encouraged to develop their educational tools that are tailored to their own needs. Our simulator can help our colleagues who want to teach POCUS and cannot purchase expensive mannequins and computer-based simulators.


Basic physics; Fanning; Learning; Point-of-care; Simulation; Teaching; Ultrasound

Conflict of interest statement

There were no human participants neither animals in this study and an ethical approval is not required.Not applicable.None declared by the authors.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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