Development and evaluation of a novel cadaveric model for performance of image-guided percutaneous renal tumor ablation

Lightly Embalmed Cadavers in Sonography Education: A Novel Approach to Improving Students’ Perceived Competence in Renal Biopsy Procedures

Objective:

To determine if a simulation lab using lightly embalmed cadavers would improve diagnostic medical sonography (DMS) students’ perceived competence in ultrasound-guided native renal biopsy examinations.

Methods:

Subjects included DMS students (n = 49) enrolled in academic years 2012 to 2018. Each DMS student performed a native renal biopsy with a nephrology fellow. Skills practiced included machine setup, inferior renal pole localization, biopsy guide preparation, needle visualization, and communication skills. Pre- and postlab surveys assessed DMS students’ perceived competence.

Results:

Prelab, 12% (n = 6) of students felt competent to assist in the procedure. Postlab, 61% (n = 35) of students felt competent, a statistically significant ( P < .001) change. All students viewed the lab as a valuable experience. Hands-on experience (53%), student/physician collaboration (33%), and low-stress environment (13%) were reported themes. Additional resources (50%) and scheduling (22%) were areas for improvement.

Conclusion:

A renal biopsy simulation lab using lightly embalmed cadavers is an effective method to improve DMS students’ perceived competence in this procedure.

A novel cadaveric simulation program in urology

OBJECTIVE

To evaluate the urology human cadaver training program developed by the British Association of Urological Surgeons.

DESIGN

This prospective, observational comparative study recruited urology residents, with different levels of experience, in 2 sessions of a 3-day modular cadaveric operative urology training. Participants performed various procedures on fresh-frozen cadaveric specimens, as per module, supervised by certified urological surgeons. At the conclusion of each module, all residents and faculty were invited to complete an evaluation survey.

SETTING

The training days were hosted by the British Association of Urological Surgeons at the University of Manchester Surgical Skills and Simulation Centre.

PARTICIPANTS

A total of 81 urology residents were recruited, with a maximum of 14 participants attending each module, over 2 sessions. We allocated 2 participants to each cadaver with access to all necessary equipment and guidance.

RESULTS

A total of 102 evaluation surveys were received from the trainees and faculty; a response rate of 94%. All procedures scored a mean of 3 on 5 for face validity, which is higher than the acceptability range. Regarding content validity, participants and faculty rated all aspects ≥3 on 5. Respondents held a positive view of the cadaver sessions and believed them to be useful for learning anatomy and steps of an operation (mean = 4.54) and as a confidence booster for performing a procedure (mean = 4.33). Furthermore, it was thought that the training program significantly improved skills (mean = 4.11), gave transferrable skills for the operating room (mean = 4.21), and was feasible to be incorporated into training programs (mean = 4.29). Human cadaveric simulation was rated as the best mode of simulation-based training for all the procedures in the curriculum.

CONCLUSIONS

This study on cadaveric simulation training demonstrated face and content validities. It also showed feasibility, acceptability, a high value for educational influence and cost-effectiveness for cadaveric simulation. A simulation-based training pathway has been proposed for effective procedural training in urology.

A novel cadaver-based educational program in general surgery training

OBJECTIVE

To describe the development of a cadaver-based educational program and report our residents' assessment of the new program.

DESIGN

An anatomy-based educational program was developed using fresh frozen cadavers to teach surgical anatomy and operative skills to general surgery (GS) trainees. Residents were asked to complete a voluntary, anonymous survey evaluating perceptions of the program (6 questions formulated on a 5-point Likert scale) and comparing cadaver sessions to other types of learning (4 rank order questions).

SETTING

Large university teaching hospital.

PARTICIPANTS

Medical students, residents, and faculty members were participants in the cadaver programs. Only GS residents were asked to complete the survey.

RESULTS

Since its implementation, 150 residents of all levels participated in 13 sessions. A total of 40 surveys were returned for a response rate of 89%. Overall, respondents held a positive view of the cadaver sessions and believed them to be useful for learning anatomy (94% agree or strongly agree), learning the steps of an operation (76% agree or strongly agree), and increasing confidence in doing an operation (53% agree or strongly agree). Trainees wanted to have more sessions (87% agree or strongly agree), and believed they would spend free time in the cadaver laboratory (58% agree or strongly agree). Compared with other learning modalities, cadaver sessions were ranked first for learning surgical anatomy, followed by textbooks, simulators, web sites, animate laboratories, and lectures. Respondents also ranked cadaver sessions first for increasing confidence in performing a procedure and for learning the steps of an operation. Cost of cadavers represented the major expense of the program.

CONCLUSIONS

Fresh cadaver dissections represent a solution to the challenges of efficient, safe, and effective general surgery education. Residents have a positive attitude toward these teaching sessions and found them to be more effective than other learning modalities.