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一种提高宫颈细针穿刺诊断准确性的新型训练模型。

A Novel Training Model to Improve Diagnostic Accuracy of Cervical Fine-Needle Aspiration.

作者信息

Anschuetz Lukas, Tschopp Samuel, Trippel Mafalda, Huwendiek Sören, Trepp Roman, Caversaccio Marco, von Werdt Moritz, Borner Urs

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.

Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Lausanne (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.

出版信息

Head Neck. 2025 Apr;47(4):1256-1263. doi: 10.1002/hed.28039. Epub 2024 Dec 19.

Abstract

INTRODUCTION

This study aims to improve the diagnostic yield of cervical fine-needle aspiration (FNA) through training on a novel liver model. Ultrasonography-guided fine-needle aspiration (US-FNA) is crucial for diagnosing head and neck lumps but requires meticulous execution. Limited resources often hinder systematic teaching, making practical models essential for training.

METHODS

Fifteen otorhinolaryngology residents trained using a liver model with inserted Sensorium spheres to simulate cervical masses. The training involved viewing an instructional video, performing US-FNA on the model, and completing pre- and posttraining self-assessments. Performance was evaluated using visual analog scales (VAS), an adapted version of objective structured assessment of ultrasound skills (adapted OSAUS), and timing of procedures. Clinical impact was assessed by comparing diagnostic rates of US-FNA before and after training.

RESULTS

Participants reported increased comfort and proficiency in US-FNA techniques posttraining. Adapted OSAUS scores improved significantly for image recognition and both in-plane and out-of-plane techniques. The diagnostic yield of US-FNA in clinical practice increased from 71% to 85%. No significant influence of gender, preferred ultrasound orientation, age, or experience on the learning curve was found. However, male participants showed a more substantial benefit from the training.

CONCLUSION

The liver model effectively enhances US-FNA skills, reflected in improved clinical diagnostic rates. Training on such models should be incorporated into medical education to reduce inconclusive punctures and enhance patient satisfaction. This study demonstrates the feasibility and effectiveness of a cost-efficient, reproducible model for US-FNA training, emphasizing the importance of practical training in medical education.

摘要

引言

本研究旨在通过在一种新型肝脏模型上进行培训,提高宫颈细针穿刺活检(FNA)的诊断率。超声引导下细针穿刺活检(US-FNA)对于诊断头颈部肿块至关重要,但需要精心操作。资源有限常常阻碍系统教学,因此实用模型对于培训至关重要。

方法

15名耳鼻咽喉科住院医师使用植入了Sensorium球的肝脏模型进行培训,以模拟宫颈肿块。培训包括观看教学视频、在模型上进行US-FNA以及完成培训前和培训后的自我评估。使用视觉模拟量表(VAS)、超声技能客观结构化评估的改编版(改编后的OSAUS)以及操作时间来评估表现。通过比较培训前后US-FNA的诊断率来评估临床影响。

结果

参与者报告称培训后在US-FNA技术方面的舒适度和熟练度有所提高。改编后的OSAUS在图像识别以及平面内和平面外技术方面的得分均显著提高。临床实践中US-FNA的诊断率从71%提高到了85%。未发现性别、偏好的超声方向、年龄或经验对学习曲线有显著影响。然而,男性参与者从培训中获益更大。

结论

肝脏模型有效提高了US-FNA技能,这体现在临床诊断率的提高上。应将此类模型的培训纳入医学教育,以减少不确定的穿刺并提高患者满意度。本研究证明了一种用于US-FNA培训的经济高效、可重复模型的可行性和有效性,强调了医学教育中实践培训的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f2a/11907678/b12d6350cef2/HED-47-1256-g002.jpg

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