Ultrasound-guided procedures in medical education: a fresh look at cadavers

Abstract

Demand for bedside ultrasound in medicine has created a need for earlier exposure to ultrasound education during the clinical years of undergraduate medical education. Although bedside ultrasound is often used for invasive medical procedures, there is no standardized educational model for procedural skills that can provide the learner a real-life simulated experience. The objective of our study was to describe a unique fresh cadaver preparation model, and to determine the impact of a procedure-focused ultrasound training session. This study was a cross-sectional study at an urban academic medical center. A sixteen-item questionnaire was administered at the beginning and end of the session. Fifty-five third year medical students participated in this 1-day event during their surgical clerkship. Students were trained to perform the following ultrasound-guided procedures: internal jugular vein cannulation, femoral vein cannulation femoral artery cannulation and pericardiocentesis. Preparation of the fresh cadaver is easily replicated and requires minor manipulation of cadaver vessels and pericardial space. Fifty-five medical students in their third year participated in this study. All of the medical students agreed that US could help increase their confidence in performing procedures in the future. Eighty percent (95 % CI 70-91 %) of students felt that there was a benefit of learning ultrasound-based anatomy in addition to traditional methods. Student confidence was self-rated on a five-point Likert scale. Student confidence increased with statistical significance in all of the skills taught. The most dramatic increase was noted in central venous line placement, which improved from 1.95 (SD = 0.11) to 4.2 (SD = 0.09) (p < 0.001). The use of fresh cadavers for procedure-focused US education is a realistic method that improves the confidence of third year medical students in performing complex but critical procedures.

A Scoping Review of Ultrasound Teaching in Undergraduate Medical Education

“…Procedures [82][83][84][85][86][87][88][89][90][91] Ultrasound has been used in conjunction with 'phantom' simulators [82][83][84][85] or cadavers [86,87] to teach invasive procedures such as venous and arterial line placement and nerve blocks. McCrary et al [88] used a fresh cadaver model to teach ultrasound-guided breast biopsy to medical students on surgery clerkship.…”

“…The evidence supports the use of simulators as well as several novel low-cost teaching tools for the less well-resourced educator. Ultrasound can also complement cadaver-based teaching, allowing invasive interventional skills (central line placement [85,86], pericardiocentesis [87], surgical biopsy [88]) to be taught on realistic anatomy without compromising patient safety. Where cadavers are not available, ultrasound simulators and phantoms can fulfil a similar role.…”

Cadaver-based abscess model for medical training

“…The use of cadavers as a platform for ultrasound training has been shown to increase student confidence in performing future ultrasound-guided skills at our institution 9,10. In addition to a fresh cadaver, the following materials are needed to prepare this training model: a latex balloon, ultrasound gel, normal saline, a number 11 or 15 blade, and an 18-guage needle with 10 cc syringe.…”

Cadaver-based Necrotizing Fasciitis Model for Medical Training

“…Currently, there are no realistic models that provide the learner with the opportunity to evaluate and identify the sonographic findings for NF. With the increased utilization of diagnostic ultrasound in medical practice and residency training, educational models must incorporate the use of ultrasound in these medical training models [5-10]. Teaching models for highly morbid and rare conditions such as NF have been shown to improve diagnostic accuracy as well as clinical management of such patients, and in particular, cadaver-based models have been shown to improve ultrasound-guided techniques [5,10].…”