Sekhar Aarti, Sun Maryellen R, Siewert Bettina
Emory University Hospital, 1365 Clifton Rd, NE, Atlanta, GA 30322.
Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Acad Radiol. 2014 Jul;21(7):902-8. doi: 10.1016/j.acra.2014.03.002.
The apprenticeship model for training of percutaneous liver biopsy has limitations, and costs of commercially available simulation models can be prohibitive. We created an inexpensive tissue phantom for liver biopsy simulation and evaluated the utility of this model for training radiology residents.
A bovine-porcine tissue phantom was devised as a simulation model and consisted of bovine liver with a porcine rib layer and inserted pimento olives simulating target lesions. Training sessions (a 20-minute didactic lecture and a 90-minute practice session) were offered to all residents in a diagnostic radiology residency. Effect of training was assessed by questionnaire before and after training. Level of knowledge of topics covered in the didactic session, confidence in technical skills, and anxiety level were evaluated on a five-point scale (1, poor to 5, excellent).
Thirty-five of 38 residents received training on the models (~$40). Mean reported value score for training was 4.88/5. Improvement was greatest for knowledge of technique (2.3-4.1/5, P < .001) and knowledge of postprocedure care (2.2-4.1/5, P < .001). Technical confidence increased (2.4-3.8/5, P < .001) and anxiety related to performing liver biopsy improved (2.7-3.7/5, P < .001). Residents with no prior experience in liver biopsy (n = 21) had significantly greater increases in all categories than residents with prior experience (n = 14), except for knowledge about obtaining informed consent and anxiety levels.
Utilization of an inexpensively created bovine/porcine liver biopsy simulation model was well perceived by radiology residents and can be used as an educational tool during residency.
经皮肝穿刺活检的学徒培训模式存在局限性，且市售模拟模型的成本可能过高。我们制作了一种用于肝穿刺活检模拟的低成本组织模型，并评估了该模型在培训放射科住院医师方面的效用。
设计了一种牛 - 猪组织模型作为模拟模型，其由带有猪肋骨层的牛肝和插入的模拟靶病变的甜椒橄榄组成。为诊断放射科住院医师提供培训课程（20分钟的理论讲座和90分钟的实践课程）。通过培训前后的问卷调查评估培训效果。在五分制量表（1，差至5，优）上评估理论课程涵盖主题的知识水平、技术技能信心和焦虑程度。
38名住院医师中有35名接受了该模型的培训（约40美元）。报告的培训平均价值评分为4.88/5。技术知识（2.3 - 4.1/5，P <.001）和术后护理知识（2.2 - 4.1/5，P <.001）的改善最为显著。技术信心增强（2.4 - 3.8/5，P <.001），与进行肝穿刺活检相关的焦虑得到改善（2.7 - 3.7/5, P <.001）。除了关于获得知情同意的知识和焦虑程度外，之前没有肝穿刺活检经验的住院医师（n = 21）在所有类别中的增加幅度均明显大于有经验的住院医师（n = 14）。
放射科住院医师对自制的低成本牛/猪肝穿刺活检模拟模型评价良好，可在住院医师培训期间用作教育工具。
