McCrary Hilary C, Faucett Erynne A, Hurbon Audriana N, Milinic Tijana, Cervantes Jose A, Kent Sean L, Adamas-Rappaport William J
1 University of Arizona College of Medicine-Tucson, Arizona, USA.
2 University of Arizona Department of Otolaryngology-Head and Neck Surgery, Tucson, Arizona, USA.
Otolaryngol Head Neck Surg. 2017 Jul;157(1):30-35. doi: 10.1177/0194599817699596. Epub 2017 Apr 18.
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.
目的 我们研究的目的是确定用于指导超声（US）引导下甲状腺结节细针穿刺抽吸（FNA）的新鲜尸体模型（FCM）是否为一种实用的指导方法。研究设计 对医学生在新鲜尸体甲状腺旁人工制造的甲状腺结节上进行US引导下FNA的能力进行指导前和指导后的评估。地点 基于大学的新鲜尸体实验室。对象与方法 研究参与者包括总共17名接受过最少US培训的一年级和二年级医学生。使用一份包含10项内容的清单评估技术技能。此外，还完成了一项关于该操作的适应证、禁忌证和并发症的认知评估。在初次评估5周后为参与者提供指导后评估。使用McNemar检验分析技术技能指导前和指导后评估分数之间的差异。使用配对双样本t检验分析平均认知知识增益。结果 技能清单上的10项中有8项在指导前和指导后技能评估之间具有统计学意义（P < .05）。关于该操作禁忌证的认知知识增益有统计学意义的变化（P = .001），但适应证或并发症方面没有（分别为P = .104和P = .111）。结论 US引导下FNA仍然是甲状腺结节检查中的一项重要诊断程序，使其成为纳入外科技能实验室的一项基本技能。我们用于指导US引导下FNA的FCM是同类中的首个，这项初步研究表明这是一种可行的指导方法。
