Current Experience of Ultrasound Training in Otolaryngology Residency Programs

Meister, Kara D; Vila, Peter M.; Bonilla‐Velez, Juliana; Sebelik, Merry; Orloff, Lisa A.

doi:10.1002/jum.14700

Cited by 8 publications

(6 citation statements)

References 7 publications

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“…Ultrasonography is known to be highly operator dependent, and the extent of formal or informal training on its use varies . A recent survey of otolaryngology residents found that 44% reported not feeling comfortable performing ultrasonography-guided procedures, and 43% reported not having performed any as part of their residency training . Formal ultrasonography training is offered by the American College of Surgeons, and a study of physician sonographers found that surgeons who had successfully completed training were more likely to correctly identify cervical lymph node status than nonsurgeon sonographers …”

Section: Discussionmentioning

confidence: 99%

Physician Confidence in Neck Ultrasonography for Surveillance of Differentiated Thyroid Cancer Recurrence

Kovatch

Reyes‐Gastelum

Sipos

et al. 2021

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE Neck ultrasonography, a mainstay of long-term surveillance for recurrence of differentiated thyroid cancer (DTC), is routinely used by endocrinologists, general surgeons, and otolaryngologists; however, physician confidence in their ability to use ultrasonography to identify lymph nodes suggestive of cancer recurrence remains unknown.OBJECTIVE To evaluate physicians' posttreatment surveillance practices for DTC recurrence, specifically their use of and confidence in ultrasonography. DESIGN, SETTING, AND PARTICIPANTSCross-sectional study of 448 physicians in private and academic hospitals who completed a survey on DTC posttreatment practices from October 2018 to August 2019 (response rate, 69%) and self-reported involvement in long-term surveillance for thyroid cancer recurrence. Physicians were identified by patients affiliated with the Surveillance, Epidemiology, and End Results Program registries in Georgia State and Los Angeles County. Of the respondents, 320 physicians who reported involvement with DTC surveillance were included in the analysis.MAIN OUTCOMES AND MEASURES Physician-reported long-term surveillance practices for DTC, including frequency of use and level of confidence in ultrasonography for detecting lymph nodes suggestive of cancer recurrence. RESULTSIn the cohort of 320 physicians who reported involvement with DTC surveillance, 186 (60%) had been in practice for 10 years to less than 30 years; 209 (68%) were White; and 212 (66%) were men. The physicians included 170 (56%) endocrinologists, 67 (21%) general surgeons, and 75 (23%) otolaryngologists. Just 84 (27%) physicians reported personally performing bedside ultrasonography. Only 57 (20%) had high confidence (rated quite or extremely confident) in their ability to use bedside ultrasonography to identify lymph nodes suggestive of recurrence; 94 (33%) did not report high confidence in either their ability or a radiologist's ability to use ultrasonography to detect recurrence. Higher confidence in ultrasonography was associated with the general surgery subspecialty (odds ratio [OR], 5.7; 95% CI, 2.2-14.4; reference endocrinology) and with treating a higher number of patients per year (>50 patients: OR, 14.4; 95% CI,[31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50] 8.4; 95% CI,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] 4.3; 95% CI,.1; reference 0-10 patients).CONCLUSIONS AND RELEVANCE Given the importance of neck ultrasonography in long-term surveillance for thyroid cancer, these findings of physicians' low confidence in their own ability and that of radiologists to use ultrasonography to detect recurrence point to a major obstacle to standardizing long-term DTC surveillance practices.

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Section: Discussionmentioning

confidence: 99%

Physician Confidence in Neck Ultrasonography for Surveillance of Differentiated Thyroid Cancer Recurrence

Kovatch

Reyes‐Gastelum

Sipos

et al. 2021

JAMA Otolaryngol Head Neck Surg

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“…Learning these skills requires good training and a lot of experience in interventional ultrasound [7].…”

Section: Discussionmentioning

confidence: 99%

“…Ultrasound-guided punch biopsy and puncture are cost-effective, accurate, and low-risk methods for this [5,6]. Learning these skills requires good training and a lot of experience in interventional ultrasound [7]. There are many commercially available ultrasound models for training purposes.…”

Section: Discussionmentioning

confidence: 99%

Low-cost simulation model for ultrasound-guided punch biopsy and puncture: Construction manual and photo examples

Lüdke,

Paliege,

Kluge

et al. 2024

Ultraschall Med

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Purpose Ultrasound-guided puncture and punch biopsy pose a particular challenge in the training of ultrasound examination. These techniques should be learned and performed several times before being applied to the patient using a simulation model that is as realistic as possible. While the use of agar-agar-based models is extensively documented in the literature, there is a discernible gap in publications specifically addressing their use in punch biopsy and puncture. The aim was to develop a cost-effective model for the simulation of ultrasound-guided interventions. Material and Methods The developed simulation model is based on the vegetable gelatine agar-agar. The agar-agar powder is boiled in water and coloured. Various objects are added to the mass. Blueberries, olives, tomatoes and cornichons imitate solid structures. Liquid-filled balloons are used to simulate cystic structures. Adding stones can make the exercises more difficult due to hyperechoic reflexes with distal shadowing. Results With the model, ultrasound-guided punctures and punch biopsies could be successfully simulated, and ultrasound images generated for this purpose. The cost of a single model is about 2 euros. The production takes less than 2 hours, including cooling. The pure processing time is 30 minutes. The durability of the models is limited by mould, which occurs after 5 days when stored in room air and after 5 weeks in the refrigerator. Conclusion It was shown that it is possible to produce an inexpensive agar-agar-based ultrasound model in a short time and with easily available ingredients to learn ultrasound-guided punctures and punch biopsies. Ziel Ultraschallgestützte Punktionen und Stanzbiopsien stellen eine besondere Herausforderung in der Ausbildung von Ultraschalluntersuchungen dar. Diese Techniken sollten bestenfalls vor der Anwendung am Patienten durch realistische Simulationsmodelle erlernt werden. Der Einsatz von Modellen zur Erlernung von ultraschallgestützten Stanzbiopsien und Punktionen ist bisher kaum beschrieben. Ziel war es, ein kostengünstiges Modell zur Simulation ultraschallgestützter Interventionen herzustellen. Material und Methoden Das entwickelte Simulationsmodell basiert auf pflanzlicher Gelatine. Das Gelatine-Pulver wird in Wasser aufgekocht und gefärbt. Beim Gießen des Modells werden verschiedene Objekte der Masse hinzugefügt. Mit Blaubeeren, Oliven und Tomaten können solide Strukturen imitiert werden. Flüssigkeitsgefüllte Ballons simulieren zystische Strukturen. Das Hinzufügen von Steinen kann die Übungen erschweren. Ergebnisse Mit dem beschriebenen Modell können ultraschallgestützte Punktionen und Stanzbiopsien erfolgreich simuliert und hierfür Ultraschallbilder generiert werden. Die Kosten eines Simulationsmodells betragen ca. 2 Euro. Die Herstellung dauert inklusive des Abkühlens ca. 3 Stunden. Die reine Arbeitszeit beträgt 30 min. Nach dem Abkühlen ist das Modell sofort einsatzfähig. Schimmelbildung zeigt sich bei Lagerung an der Raumluft nach 5 Tagen und im Kühlschrank nach 5 Wochen. Schlussfolgerung Es konnte gezeigt werden, dass es möglich ist, ein kostengünstiges Ultraschallmodell in kurzer Zeit und mit einfach verfügbaren Inhaltsstoffen für das Erlernen von ultraschallgestützten Punktionen und Stanzbiopsien auf der Basis von Agar-Agar herzustellen.

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“…Still, only a few countries have incorporated formal ultrasound training into their otolaryngology residency programs 11 . A study from the United States found strong interest in surgeon‐performed ultrasound among 78% of the otolaryngology residents, while only 24% had attended a formal ultrasound course 12 . Hands‐on courses are also associated with considerable monetary cost and faculty time, and transferring skills learned in a simulated setting to clinical practice can be difficult 13 .…”

Section: Introductionmentioning

confidence: 99%

Head and neck ultrasound training improves the diagnostic performance of otolaryngology residents

Warm,

Melchiors,

Kristensen

et al. 2024

Laryngoscope Investig Oto

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ObjectiveSurgeon‐performed head and neck ultrasound (US) is increasingly used among otolaryngologists in office‐based and surgical settings. However, it is unknown how formal US training affects otolaryngology residents' diagnostic workup of patients with cervical pathology. This study examined how a formal US course for residents affected their outpatient clinic US performance and diagnostic accuracy.MethodsWe conducted a randomized cross‐over trial, where 13 otolaryngology residents participated in a 6‐h formal US course. Participants were randomized to perform head and neck US on four patient cases before and after completing the course. Eight patients with and without neck pathology were invited to participate as test cases. The ultrasound examinations were video recorded and anonymized before two consultants rated the US performance using the Objective Structured Assessment of Ultrasound Skills (OSAUS) scale. Otolaryngology residents wrote an ultrasound report with a diagnosis based on their US examination, which was used to calculate the specificity and sensitivity.ResultsWe found a statistically significant difference in the OSAUS score before compared to after the hands‐on training (p = .035). The diagnostic accuracy also increased from 62% before the course to 75% after the course (p = .02). Specificity increased from 54% prior to the course to 62% following the course, and sensitivity increased from 64% prior to the course to 79% following the course. The intraclass correlation coefficient with “absolute agreement” was 0.63.ConclusionThis study demonstrates that short, formal ultrasound training can improve otolaryngology residents' ultrasound skills and diagnostic accuracy in an outpatient clinic setting.Lay summaryThis study looks at the change of otolaryngology residents' diagnostic workup of patients after they take a formal ultrasound course and shows that they get better at using ultrasound and make more accurate diagnoses if they take a formal course.Level of EvidenceLevel 2.

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Current Experience of Ultrasound Training in Otolaryngology Residency Programs

Cited by 8 publications

References 7 publications

Physician Confidence in Neck Ultrasonography for Surveillance of Differentiated Thyroid Cancer Recurrence

Physician Confidence in Neck Ultrasonography for Surveillance of Differentiated Thyroid Cancer Recurrence

Low-cost simulation model for ultrasound-guided punch biopsy and puncture: Construction manual and photo examples

Head and neck ultrasound training improves the diagnostic performance of otolaryngology residents

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