Learning curve of radiology residents during training in fluoroscopy-guided facet joint injections

Abstract

Objective:To develop a simulator for training in fluoroscopy-guided facet joint injections and to evaluate the learning curve for this procedure among radiology residents.Materials and Methods:Using a human lumbar spine as a model, we manufactured five lumbar vertebrae made of methacrylate and plaster. These vertebrae were assembled in order to create an anatomical model of the lumbar spine. We used a silicon casing to simulate the paravertebral muscles. The model was placed into the trunk of a plastic mannequin. From a group of radiology residents, we recruited 12 volunteers. During simulation-based training sessions, each student carried out 16 lumbar facet injections. We used three parameters to assess the learning curves: procedure time; fluoroscopy time; and quality of the procedure, as defined by the positioning of the needle.Results:During the training, the learning curves of all the students showed improvement in terms of the procedure and fluoroscopy times. The quality of the procedure parameter also showed improvement, as evidenced by a decrease in the number of inappropriate injections.Conclusion:We present a simple, inexpensive simulation model for training in facet joint injections. The learning curves of our trainees using the simulator showed improvement in all of the parameters assessed.

Current State of Three-Dimensional Printing for Simulation Training of Interventional Radiology Trainees

“…Current simulation options are varied, ranging from video games for inferior vena cava filter placement or percutaneous image-guided interventions [14,15], phantom simulators for Computed Tomography (CT) biopsies [10,[16][17][18], or animal or cadaver models to practice endovascular access or interventions [13,19]. Several studies have used simulators to demonstrate improved procedural technique, either in device manipulation [20][21][22], successful vessel cannulation [23], or reduced procedural time and radiation use [24][25][26]. There is burgeoning evidence demonstrating skill retention after the simulation [7], which has translated to improved patient outcomes.…”

Visuospatial skills are better predictors than dexterity for basic ultrasonographic and fluoroscopic skills in veterinary students

“…Explicit practice and repetition are necessary to develop and maintain proficiency in medical techniques . In medical education, the traditional model of learning is based on observing and participating in live procedures, which is limited by the number of procedures available to trainees and the risk of harm to patients .…”

“…Explicit practice and repetition are necessary to develop and maintain proficiency in medical techniques . In medical education, the traditional model of learning is based on observing and participating in live procedures, which is limited by the number of procedures available to trainees and the risk of harm to patients . Procedural training simulators have gained popularity as they allow trainees to improve technical skill and develop confidence in a controlled environment without risk of harm to patients .…”

“…In medical education, the traditional model of learning is based on observing and participating in live procedures, which is limited by the number of procedures available to trainees and the risk of harm to patients . Procedural training simulators have gained popularity as they allow trainees to improve technical skill and develop confidence in a controlled environment without risk of harm to patients . Skills acquired with simulators may lead to improved performance in live‐patient procedures .…”

“…Procedural training simulators have gained popularity as they allow trainees to improve technical skill and develop confidence in a controlled environment without risk of harm to patients . Skills acquired with simulators may lead to improved performance in live‐patient procedures . Previous studies in human medicine have used simulators to assess the possibility of predicting ultrasound, endovascular, and laparoscopic surgical performance by testing innate visuospatial and psychomotor aptitude .…”