Wallace Elizabeth R, Gregoski Mathew J, Shah Aalap
Medical University of South Carolina College of Medicine Charleston South Carolina USA.
Department of Public Health Sciences College of Medicine Medical University of South Carolina Charleston South Carolina USA.
AEM Educ Train. 2024 Aug 28;8(4):e11018. doi: 10.1002/aet2.11018. eCollection 2024 Aug.
Use of ultrasound (US) for procedural needle guidance can improve success rates, safety, and accuracy. Often, training is performed on task trainers, which can be prohibitively expensive. Determining undesired needle placement is difficult when the needle is poorly visualized with US. Currently available simulation phantoms cannot provide real-time feedback on the location of needle placement.
The primary objective was to develop and determine feasibility of a low-cost simulation phantom with an internal circuit and LED light system to determine when a needle contacts internal structures. We also aimed to determine whether its use was associated with increased comfort level.
Emergency medicine (EM) residents (PGY-1 to PGY-3) performed in-plane and out-of-plane US needle guidance using homemade phantoms. Comfort levels were assessed by pre- and post intervention survey. Outcomes were measured on Likert scale (minimum = 1, maximum = 5). The primary outcome was change in confidence markers before and after the simulation task. Secondary outcomes were survey results of comparisons of these models to prior training experiences on simulators and humans.
All EM residents (30) in our program were invited to participate. Twenty participants enrolled and completed the study. In the primary outcome, median comfort with out-of-plane and in-plane guidance increased after using the model but was more pronounced for out-of-plane guidance. On a posttest survey, residents rated the models overall very similar to prior experience on simulators (median 5/5 [IQR 4.0-5.0]) and moderately similar to humans (median 3/5 [IQR 3.0-4.0]).
We created a low-cost ballistic gelatin phantom with an internal electric needle guidance system. Use of the phantom for training was associated with increased learner comfort with the procedure. Learners rated the characteristics of the phantom as similar to higher-cost commercial equipment and humans.
使用超声（US）进行操作针引导可提高成功率、安全性和准确性。通常，培训是在任务训练器上进行的，这可能成本过高。当超声难以清晰显示针时，确定针的不当放置很困难。目前可用的模拟模型无法提供关于针放置位置的实时反馈。
主要目的是开发一种具有内部电路和LED灯系统的低成本模拟模型，以确定针何时接触内部结构，并确定其可行性。我们还旨在确定其使用是否与舒适度提高相关。
急诊医学（EM）住院医师（PGY-1至PGY-3）使用自制模型进行平面内和平面外超声针引导。通过干预前后的调查评估舒适度。结果采用李克特量表测量（最小值=1，最大值=5）。主要结果是模拟任务前后信心指标的变化。次要结果是这些模型与先前在模拟器和人体上的训练经验比较的调查结果。
我们项目中的所有30名EM住院医师均被邀请参加。20名参与者登记并完成了研究。在主要结果中，使用模型后平面外和平面内引导的中位舒适度增加，但平面外引导更为明显。在一项测试后调查中，住院医师对模型的总体评价与先前在模拟器上的经验非常相似（中位数5/5[四分位间距4.0-5.0]），与人体的相似度中等（中位数3/5[四分位间距3.0-4.0]）。
我们创建了一种带有内部电针引导系统的低成本弹道明胶模型。使用该模型进行训练可提高学习者对该操作的舒适度。学习者将该模型的特性评为与成本更高的商业设备和人体相似。
