Standifird Colin, Triplett Hunter E, Bassett Charlton, Norman Kaden, Ames Emily, Levy Joshua, Moreno Marvi, Lauria Michael, Sulkowski Kathryn, Simanton Edward, Kang Eugene
Emergency Medicine, Kirk Kerkorian School of Medicine at UNLV (University of Nevada, Las Vegas), Las Vegas, USA.
Emergency, Kirk Kerkorian School of Medicine at UNLV (University of Nevada, Las Vegas), Las Vegas, USA.
Cureus. 2024 Sep 25;16(9):e70181. doi: 10.7759/cureus.70181. eCollection 2024 Sep.
Introduction Simulation tools are crucial in medical education but current commercial models for ultrasound-guided intravenous (IV) access lack complexity and can be prohibitively expensive. This article proposes a cost-effective gel model system that replicates realistic vein and artery interactions, addressing the limitations of traditional models. An advanced gelatin model was constructed that incorporates intricate vein and artery configurations and enhances medical training by providing a more authentic experience. Patient testing will further validate its efficacy, promising improved accessibility for skill refinement in resource-constrained environments. Methods In a controlled study at the Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas, 12 medical students with limited ultrasound experience participated in a workshop using novel and Blue Phantom™ models for ultrasound-guided IV catheter placement. The advanced gelatin model, created with Ziplock™ Tupperware®, ultrasonography gel-filled balloons, and gelatin, proved more effective, as assessed by participants' post-training comfort levels. The comparison of participants' pre- and post-training comfort levels with the models was the primary study objective. Participants were asked to complete a confidence survey based on a five-point Likert scale, and after using both models, this survey was re-administered to assess the participant's level of comfort after model use. The statistical analysis comparison of post-training survey data to the pre-training survey data was accomplished using SPSS version 29 (IBM Corp, Armonk, NY), where a paired t-test was set at a significance threshold of p <0.05. Results Analysis of data from both commercially made and advanced ultrasound-guided IV models using a paired t-test revealed a significant advantage for the advanced model. Participants, despite limited ultrasound experience, reported feeling over 4 points higher in skill confidence (p = 0.004) with the advanced model. Its popularity stems from diverse vasculature modeling, proving effective for both experienced practitioners and inexperienced individuals, maintaining value as user skill levels increase. Conclusion This study proposes an advanced model for ultrasound-guided peripheral IV access training, demonstrating a statistically significant increase in confidence levels. Despite limitations such as small sample size and single-site participation, the advanced model's adaptability and cost-effectiveness make it a strong contender for replacing current commercial models, potentially enhancing proficiency and confidence while reducing costs.
引言 模拟工具在医学教育中至关重要,但当前用于超声引导下静脉(IV)穿刺的商业模型缺乏复杂性且成本过高。本文提出了一种具有成本效益的凝胶模型系统,该系统可复制逼真的静脉和动脉相互作用,解决了传统模型的局限性。构建了一种先进的明胶模型,该模型纳入了复杂的静脉和动脉结构,并通过提供更真实的体验来加强医学培训。患者测试将进一步验证其有效性,有望在资源有限的环境中提高技能提升的可及性。方法 在拉斯维加斯内华达大学柯克·科尔科里安医学院进行的一项对照研究中,12名超声经验有限的医学生参加了一个使用新型模型和Blue Phantom™模型进行超声引导下IV导管置入的工作坊。由Ziplock™特百惠容器、填充超声凝胶的气球和明胶制成的先进明胶模型,经参与者培训后的舒适度评估,证明更有效。比较参与者在使用模型前后的舒适度是主要研究目标。要求参与者根据五点李克特量表完成一份信心调查问卷,在使用两种模型后,重新进行该调查以评估参与者在使用模型后的舒适度水平。使用SPSS 29版(IBM公司,纽约州阿蒙克)对培训后调查数据与培训前调查数据进行统计分析比较,其中配对t检验的显著性阈值设定为p<0.05。结果 使用配对t检验对商业制造的和先进的超声引导IV模型的数据进行分析,结果显示先进模型具有显著优势。尽管参与者超声经验有限,但他们报告称使用先进模型时技能信心高出4分以上(p = 0.004)。其受欢迎程度源于多样的血管系统建模,对有经验的从业者和无经验的个人都有效,随着用户技能水平的提高仍保持价值。结论 本研究提出了一种用于超声引导下外周IV穿刺培训的先进模型,证明信心水平有统计学意义的提高。尽管存在样本量小和单地点参与等局限性,但先进模型的适应性和成本效益使其成为取代当前商业模型的有力竞争者,有可能提高熟练程度和信心,同时降低成本。