A Fresh Cadaver Model for the Instruction of Ultrasound‐Guided Fine‐Needle Aspiration of Thyroid Nodules

Abstract

Objective The aim of our study is to determine if a fresh cadaver model (FCM) for the instruction of ultrasound (US)-guided fine-needle aspiration (FNA) of thyroid nodules is a practical method for instruction. Study Design Pre- and postinstruction assessment of medical students' ability to perform US-guided FNA of artificially created thyroid nodules placed adjacent to the thyroid gland of a fresh cadaver. Setting University-based fresh cadaver laboratory. Subjects and Methods Study participants included a total of 17 first- and second-year medical students with minimal US training. Technical skills were assessed using a 10-item checklist. In addition, a cognitive assessment regarding the indications, contraindications, and complications of the procedure was completed. A postinstruction assessment was provided for participants 5 weeks after their initial assessment. Differences between pre- and postinstruction assessment scores of technical skills were analyzed using McNemar's test. The mean cognitive knowledge gain was analyzed using a paired 2-sample t test. Results Eight of 10 items on the skills checklist were statistically significant between pre- and postinstruction skills assessment ( P < .05). There was a statistically significant change in cognitive knowledge gain regarding the contraindications of the procedure ( P = .001), but not for indications or complications ( P = .104 and P = .111, respectively). Conclusion US-guided FNA continues to be an important diagnostic procedure in the workup of thyroid nodules, making it an essential skill to integrate into surgical skills lab. Our FCM for the instruction of US-guided FNA is the first of its kind, and this pilot study shows this is a viable method for instruction.

Benchtop fine needle aspirations: An untapped source of cytologic educational material

“…For example, a pilot study by a group from the University of Arizona showed that medical students could successfully learn FNA techniques by practicing on the thyroids of cadavers. 6 In another study, Schnadig et al performed cytologic diagnosis of lesions seen at autopsy, using both scrapings and benchtop FNAs. 7 This study was a continuation of the work done by Walker and Going.…”

“…There is some literature on benchtop FNA, with studies spanning a range of applications. For example, a pilot study by a group from the University of Arizona showed that medical students could successfully learn FNA techniques by practicing on the thyroids of cadavers 6 . In another study, Schnadig et al performed cytologic diagnosis of lesions seen at autopsy, using both scrapings and benchtop FNAs 7 .…”

Assessing cytopathology milestones with checklists and online learning

“…1 Practicing on artificial models adjacent to a cadaver's thyroid or breast, medical students demonstrated improvements in technical skills related to ultrasound-guided FNA, as assessed with checklists. 2,3 Similar checklists can easily be used for instructing pathology residents and cytopathology fellows in smear preparation and FNA techniques. This type of approach, evaluating the performance of discrete tasks, will likely propagate as we move toward adopting entrustable professional activities.…”

“…A checklist has been used to assess FNA performance in surgery residents, and a short instructional video was associated with improved scores . Practicing on artificial models adjacent to a cadaver's thyroid or breast, medical students demonstrated improvements in technical skills related to ultrasound‐guided FNA, as assessed with checklists . Similar checklists can easily be used for instructing pathology residents and cytopathology fellows in smear preparation and FNA techniques.…”