Vol. 42 (4): 717-726, July – August, 2016
Pauline Filippou 1, Anobel Odisho 1, Krishna Ramaswamy 1, Manint Usawachintachit 1,2, Weiguo Hu 3, Jianxing Li 3, Thomas Chi 1
1 Department of Urology, University of California, San Francisco, CA, USA; 2 Division of Urology, Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; 3 Beijing Tsinghua Changgung Hospital, Beijing, People’s Republic of China
Introduction: To assess the effect of a hands-on ultrasound training session to teach urologic trainees ultrasound-guided percutaneous needle placement.
Materials and methods: University of California, San Francisco (UCSF) urology residents completed a time trial, placing a needle into a phantom model target under ultrasound guidance. Participants were randomized into three educational exposure groups: Group 1’s time trial occurred prior to any teaching intervention, group 2’s after experiencing a hands-on training module, and group 3’s after exposure to both the training module and one-on-one attending feedback. Needle placement speed and accuracy as well as trainees’ perceived confidence in utilizing ultrasound were measured.
Results: The study cohort consisted of 15 resident trainees. Seven were randomized to group 1, three to group 2, and five to group 3. All residents reported minimal prior ultrasound experience. Their confidence in using ultrasound improved significantly after completing the training module with the most significant improvement seen among junior residents. Time to needle placement was fastest after receiving attending feedback (46.6sec in group 3 vs. 82.7sec in groups 1 and 2, p<0.01). Accuracy also improved with attending feedback, though the number of repositioning attempts did not differ significantly between groups.
Conclusions: A hands-on training module and use of an abdominal phantom trainer increased resident confidence and skill in their use of ultrasound to guide percutaneous needle positioning. Attending feedback is critical for improving accuracy in needle guidance toward a target. Ultrasound-guided needle positioning is a teachable skill and can be applicable to multiple urologic procedures.
Keywords: Education, Percutaneous Nephrolithotomy, Ultrasonography