Using an abdominal phantom to teach urology residents ultrasound-guided percutaneous needle placement

Abstract

Introduction:To assess the effect of a hands-on ultrasound training session to teach urologic trainees ultrasound-guided percutaneous needle placement.Materials and methods:University of California, San Francisco (UCSF) urology residents completed a time trial, placing a needle into a phantom model target under ultrasound guidance. Participants were randomized into three educational exposure groups: Group 1's time trial occurred prior to any teaching intervention, group 2's after experiencing a hands-on training module, and group 3's after exposure to both the training module and one-on-one attending feedback. Needle placement speed and accuracy as well as trainees' perceived confidence in utilizing ultrasound were measured.Results:The study cohort consisted of 15 resident trainees. Seven were randomized to group 1, three to group 2, and five to group 3. All residents reported minimal prior ultrasound experience. Their confidence in using ultrasound improved significantly after completing the training module with the most significant improvement seen among junior residents. Time to needle placement was fastest after receiving attending feedback (46.6sec in group 3 vs. 82.7sec in groups 1 and 2, p<0.01). Accuracy also improved with attending feedback, though the number of repositioning attempts did not differ significantly between groups.Conclusions:A hands-on training module and use of an abdominal phantom trainer increased resident confidence and skill in their use of ultrasound to guide percutaneous needle positioning. Attending feedback is critical for improving accuracy in needle guidance toward a target. Ultrasound-guided needle positioning is a teachable skill and can be applicable to multiple urologic procedures.

Evaluating the effectiveness of a lower extremity venous phantom on developing ultrasound examination skills and confidence

“…Simulation has been used to teach scanning, ultrasound guidance for medical procedures, and to improve student confidence levels. 1,11,12,20 Simulation provides practice opportunities in a nonthreatening environment and, therefore, helps students feel more comfortable with their skills when they interact with patients and studies have shown that clinical mentors also feel students are better prepared to enter the clinical environment after simulation experiences. 12,13 While independent practice on simulators has demonstrated that students feel better prepared to enter the clinic, there is also evidence that having a sonography instructor present during these practice sessions may add to the learner’s experience.…”

“…The confidence measurement tool listed seven scanning skills similar to what others have used 19 (Table 1) for students to score their confidence in ability to perform these skills. A 10 point-scale similar to what others have used for teaching physicians needle guidance 11 was used to score confidence with 1 being low and 10 being high (Supplemental Appendix A). Students were also given a confidence measurement tool with the same scanning skills as the pre-confidence tool on day four of the study immediately after their scan lab assessment.…”

X-ray–free Ultrasound-guided Percutaneous Nephrolithotomy: How to Select the Right Patient?

“…22 Urologists therefore have few opportunities to acquire proficiency via repetition.We have demonstrated that US guidance proficiency can be obtained using a training phantom. 23 However, to use US guidance in clinical practice, interested urologists will eventually have to apply their skills in the operating room environment. Defining the patient characteristics associated with success in using US guidance for each step of PCNL is important to facilitate urologists’ comfort with acquiring this skill set.…”

Homemade ultrasound phantom for simulation of hydronephrosis

“…Thus, the use of simulation phantoms present students with not only the possibility of obtaining competence in identifying pathologies such as renal pelvis dilatation by an obstructive process, but also allows the familiarization with the US machine in order to obtain images of good quality. [7][8][9][10][11] In this paper, we describe a homemade, low cost, and quickly assembled phantom to be used as surrogate for training medical students and residents in the ultrasonographic identification of hydronephrosis.…”