Use of gelatin puzzle phantoms to teach medical students isolated ultrasound transducer movements and fundamental concepts

EURO-MUSCULUS/USPRM phantom recipe for (musculoskeletal) interventional ultrasound training

Considering the growing role of ultrasound-guided procedures in musculoskeletal medicine, training as regards these interventions is pivotal. While hands-on training on cadavers can be considered optimal, it has several drawbacks, e.g., high cost, poor availability, and technical challenges regarding preservation. Apart from cadavers, different approaches to practicing needle guidance are taught in ultrasound workshops whereby phantoms from meat (e.g., chicken breast), cheese or gelatin are used. Likewise, this article aims to provide a detailed description as to how different gelatin-based phantoms can be prepared. In line with the EURO-MUSCULUS/USPRM (European Musculoskeletal Ultrasound Study Group/Ultrasound Study Group of the International Society of Physical and Rehabilitation Medicine) protocols/background, the authors describe particular basic and advanced phantoms to be used for practicing different technical/manual skills pertaining to common ultrasound-guided procedures. The present manuscript can be considered a practical and ready-to-use "recipe book" for readers who are interested in the wide spectrum of interventional ultrasound.

How to enhance the novices' learning in ultrasound-guided procedures utilizing handmade phantoms?

INTRODUCTION

This prospective study aims to evaluate the learning effect of US-guided thoracocentesis and pericardiocentesis in novices through simulation training using handmade phantoms.

METHODS

The novices included undergraduate-year (UGY) students and first postgraduate-year (PGY-1) residents. Handmade phantoms were utilized for training and immediate assessment. Novices were re-evaluated using high-fidelity phantoms three months after training, while experienced PGY-3 emergency medicine residents were recruited and evaluated with high-fidelity phantoms simultaneously. Data on their performance, puncture time, and number of attempts were collected.

RESULTS

Thirty-six novices (18 PGY-1 and 18 UGYs) and 12 PGY-3 emergency medicine residents were recruited. Alongside clinical observation, novices demonstrated improved skill retention and performance at the 3-month assessment compared to the immediate assessment [5 (4-5) vs. 3.5 (3-4), p = 0.0005] in thoracocentesis, achieving a comparable level of proficiency with the PGY-3 emergency medicine residents [5 (4-5) vs. 5 (5), p = 0.105]. Without clinical observation, novices exhibited a decline in skill proficiency in pericardiocentesis at the 3-month assessment [3 (3-4) vs. 4 (4-4.5), p = 0.015]. The puncture time was comparable between novices and PGY-3 emergency medicine residents for both thoracocentesis and pericardiocentesis. However, novices required a greater number of puncture attempts for pericardiocentesis.

CONCLUSIONS

Novices showed superior performance in thoracocentesis but experienced skill decay in pericardiocentesis at the 3-month assessment following training with handmade phantoms. This decline may be attributed to the very low frequency of pericardiocentesis cases encountered by novices after training, as well as the higher-stakes nature of the procedure. Further investigation is needed to evaluate the long-term effects of training, skill retention, and transfer of skills to actual patient care. Additionally, research should focus on determining optimal retraining intervals for pericardiocentesis and evaluating the use of standardized pericardiocentesis videos as an alternative to clinical observation.

TRIAL REGISTRATION

Registered at ClinicalTrials.gov (NCT04792203) on March 7, 2021.

FEATURES OF THE PROCESS OF TRAINING IN EDUCATIONAL MEDICAL INSTITUTIONS OF UKRAINE AT THE PRESENT STAGE. PART 2. REACTION OF HIGHER EDUCATIONAL INSTITUTIONS TO DISTANCE LEARNING

Higher education is one of the areas most affected by the Covid-19 pandemic and martial law. Against the backdrop of severe restrictions, universities faced the issue of the existing opportunities for the implementation of educational programs, the need to change the format of the educational process with the transition mainly to electronic educational technologies. Under these conditions, it was necessary to consolidate all the forces and resources of the university community. The governments of many countries have recognized the need to provide infrastructural and technological support to educational institutions. Thanks to the institutional support of the state and relevant ministries, universities managed to reduce financial losses and implement initiatives for continuous education. These measures have contributed to the sustainability of universities. In response to the COVID-19 pandemic, educational institutions all over the world have adopted different approaches and made significant changes to the education system itself in accordance with their resources and capabilities.

Ultrasonography in undergraduate medical education: a comprehensive review and the education program implemented at Jichi Medical University

The concept of point-of-care ultrasound has been widely accepted owing to the development of portable ultrasound systems and growing body of evidence concerning its extensive utility. Thus, it is reasonable to suggest that training to use this modality be included in undergraduate medical education. Training in ultrasonography helps medical students learn basic subjects such as anatomy and physiology, improve their physical examination skills, and acquire diagnostic and procedural skills. Technological advances such as simulators, affordable handheld devices, and tele-ultrasound systems can facilitate undergraduate ultrasound education. Several reports have indicated that some medical schools have integrated ultrasound training into their undergraduate medical curricula. Jichi Medical University in Japan has been providing medical students with ultrasound education to fulfill part of its mission to provide medical care to rural areas. Vertical integration of ultrasound education into a curriculum seems reasonable to ensure skill retention and improvement. However, several issues have hampered the integration of ultrasound into medical education, including a lack of trained faculty, the need to recruit human models, requisition of ultrasound machines for training, and limited curricular space; proposed solutions include peer teaching, students as trained simulated patients, the development of more affordable handheld devices, and a flipped classroom approach with access to an e-learning platform, respectively. A curriculum should be developed through multidisciplinary and bottom-up student-initiated approaches. Formulating national and international consensuses concerning the milestones and curricula can promote the incorporation of ultrasound training into undergraduate medical education at the national level.