Resident Education of Ultrasound-Guided Procedures

Abstract

The aim of this study was to evaluate an agar model that could be used to train physicians to perform ultrasound-guided procedures. Eleven (N = 11) physical medicine and rehabilitation residents volunteered to be subjects. All subjects completed a questionnaire about their experience and comfort with ultrasound-guided procedures. In phase 1, subjects were instructed to identify specific structures and perform specific procedures on the agar models; these tasks were timed. All subjects were then given a short lecture on fundamentals of ultrasound-guided procedures and percutaneous needle tenotomy. In phase 2, subjects then performed the same tasks again on the agar model and completed the questionnaire again. Analysis was performed using paired t tests. The number of structures successfully identified significantly increased from phase 1 (mean = 1.45) to phase 2 (mean = 2.54) (P = 0.003). Time to complete the needle access task in phase 2 (mean = 258 secs) significantly decreased compared with phase 1 (mean = 394 secs) (P = 0.04). Subjectively, our participants reported that they felt more comfortable performing ultrasound-guided procedures (P = 0.005) and felt more familiar with percutaneous needle tenotomy (P = 0.00004) after using the model. In conclusion, residents demonstrated improvement in ultrasound-guided procedural skills and reported increased comfort performing these procedures after training on the agar model.

A model for training ultrasound-guided fine-needle punctures

“…Our findings, together with the promising results of other investigations in the simulated training of resident physicians in ultrasound-guided procedures 1 , 2 , 9 , 11 , as well as the proven benefits in clinical practice of using models for training, such as training in laparoscopic surgery simulators demonstrating improvements in the performance of resident physicians in the operating room procedure 14 and the use of simulation devices for instructing surgical residents and fellows in basic endovascular techniques improving resident performance in a catheter-based intervention 15 , indicate that future studies should assess whether training with models directly correlates with better clinical results in interventional radiology.…”

“…There is increasing emphasis on the use of simulation for training of ultrasound-guided procedures in medical education across multiple specialties 8 – 10 , and the use of models is a promising method for improving teaching in interventional radiology as it allows for training before initiating the procedure on patients 1 , 4 , 5 . The traditional training for interventional procedures in radiology, in which the trainee performs the procedure first on a live patient, can lead to adverse outcomes and patient dissatisfaction 11 .…”

“…Homemade and inexpensive models can improve ultrasound-guided procedural skills 11 , 12 . Studies that developed models focused on training ultrasound-guided procedures for medical residents identified improvement in ultrasound-guided procedural skills 1 , 11 , 13 and reported increased comfort and confidence in performing these procedures after training 11 , 13 .…”

A Hybrid Musculoskeletal Ultrasound Curriculum for Physical Medicine and Rehabilitation Residents—a Multi-center Pilot Program

“…Although pre-recorded videos, webinars, textbooks, and guidelines can aid self-directed learning, hands-on, in-person training has been demonstrated to be superior for skill acquisition [ 24 , 43 ]. Furthermore, real-time feedback from an expert sonographer can facilitate the process of achieving competency in MSKUS [ 44 – 47 ].…”

Longitudinal Ultrasound-Guided Injection Curriculum for Physical Medicine and Rehabilitation Residents

“…[13][14][15] While both US phantoms (injection models designed to mimic human anatomy) and embalmed cadavers may be useful for initial education, unembalmed cadaveric specimens more closely mimic live human anatomy and tissue texture. [16][17][18][19] As such, the aims of this quality improvement project were to develop a longitudinal, integrated MSK US-guided procedural curriculum with unembalmed cadaveric specimens and assess changes in PM&R resident comfort, confidence, and competence in performing common US-guided injections.…”