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      Assessing the effectiveness of a cadaveric workshop in improving resident physicians’ confidence in performing ultrasound-guided joint injections Translated title: Évaluation de l'efficacité d’ateliers de simulation sur cadavre pour renforcer la confiance en soi des médecins résidents pour réaliser des injections articulaires échoguidées

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          Implication Statement

          Our study showed that an educational workshop using a cadaveric specimen is effective in improving resident physicians’ confidence in performing ultrasound-guided, as well as landmark-based, joint injections. Participants also reported a strong interest in future cadaveric workshops on ultrasound-guided joint injections and believe such workshops would be a valuable educational resource for other physicians. Implementing cadaver-based ultrasound-guided joint injection workshops similar to the one discussed in this manuscript could be used to supplement training for these procedures in medical education and provide residents with the early experience they need to be able to perform these injections independently in clinic settings.

          Énoncé des implications de la recherche

          Notre étude montre que les ateliers de simulation sur cadavre aident les médecins résidents à acquérir de l’assurance pour pratiquer des injections articulaires guidées par échographie et repères anatomiques. Les participants ont également fait part de leur vif intérêt pour refaire des ateliers de simulation sur cadavre portant sur les injections articulaires échoguidées et estiment que de tels ateliers constitueraient une ressource éducative précieuse pour d'autres médecins. De tels ateliers sur les injections articulaires échoguidées sur cadavres peuvent être organisés en complément à la formation sur ces interventions et permettre aux résidents d’acquérir de l’expérience pratique tôt dans leur formation pour être en mesure de réaliser ces injections de manière indépendante en contexte clinique.

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          Use of simulation-based education to improve outcomes of central venous catheterization: a systematic review and meta-analysis.

          P Ronksley, Hannah Brindle, William A Ghali … (2011)
          Central venous catheterization (CVC) is increasingly taught by simulation. The authors reviewed the literature on the effects of simulation training in CVC on learner and clinical outcomes. The authors searched computerized databases (1950 to May 2010), reference lists, and considered studies with a control group (without simulation education intervention). Two independent assessors reviewed the retrieved citations. Independent data abstraction was performed on study design, study quality score, learner characteristics, sample size, components of interventional curriculum, outcomes assessed, and method of assessment. Learner outcomes included performance measures on simulators, knowledge, and confidence. Patient outcomes included number of needle passes, arterial puncture, pneumothorax, and catheter-related infections. Twenty studies were identified. Simulation-based education was associated with significant improvements in learner outcomes: performance on simulators (standardized mean difference [SMD] 0.60 [95% CI 0.45 to 0.76]), knowledge (SMD 0.60 [95% CI 0.35 to 0.84]), and confidence (SMD 0.41 [95% CI 0.30 to 0.53] for studies with single-group pretest and posttest design; SMD 0.52 (95% CI 0.23 to 0.81) for studies with nonrandomized, two-group design). Furthermore, simulation-based education was associated with improved patient outcomes, including fewer needle passes (SMD -0.58 [95% CI -0.95 to -0.20]), and pneumothorax (relative risk 0.62 [95% CI 0.40 to 0.97]), for studies with nonrandomized, two-group design. However, simulation-based training was not associated with a significant reduction in risk of either arterial puncture or catheter-related infections. Despite some limitations in the literature reviewed, evidence suggests that simulation-based education for CVC provides benefits in learner and select clinical outcomes.
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            Existing Evidence on Ultrasound-Guided Injections in Sports Medicine

            Eldra Daniels, David W Cole, Bret Jacobs … (2018)
            Office-based ultrasonography has become increasingly available in many settings, and its use to guide joint and soft tissue injections has increased. Numerous studies have been conducted to evaluate the use of ultrasound-guided injections over traditional landmark-guided injections, with a rapid growth in the literature over the past few years. A comprehensive review of the literature was conducted to demonstrate increased accuracy of ultrasound-guided injections regardless of anatomic location. In the upper extremity, ultrasound-guided injections have been shown to provide superior benefit to landmark-guided injections at the glenohumeral joint, the subacromial space, the biceps tendon sheath, and the joints of the hand and wrist. Ultrasound-guided injections of the acromioclavicular and the elbow joints have not been shown to be more efficacious. In the lower extremity, ultrasound-guided injections at the knee, ankle, and foot have superior efficacy to landmark-guided injections. Conclusive evidence is not available regarding improved efficacy of ultrasound-guided injections of the hip, although landmark-guided injection is performed less commonly at the hip joint. Ultrasound-guided injections are overall more accurate than landmark-guided injections. While current studies indicate that ultrasound guidance improves efficacy and cost-effectiveness of many injections, these studies are limited and more research is needed.
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              Ultrasound-guided procedures in medical education: a fresh look at cadavers.

              Lori Stolz, Riley Hoyer, Russel Means … (2016)
              Demand for bedside ultrasound in medicine has created a need for earlier exposure to ultrasound education during the clinical years of undergraduate medical education. Although bedside ultrasound is often used for invasive medical procedures, there is no standardized educational model for procedural skills that can provide the learner a real-life simulated experience. The objective of our study was to describe a unique fresh cadaver preparation model, and to determine the impact of a procedure-focused ultrasound training session. This study was a cross-sectional study at an urban academic medical center. A sixteen-item questionnaire was administered at the beginning and end of the session. Fifty-five third year medical students participated in this 1-day event during their surgical clerkship. Students were trained to perform the following ultrasound-guided procedures: internal jugular vein cannulation, femoral vein cannulation femoral artery cannulation and pericardiocentesis. Preparation of the fresh cadaver is easily replicated and requires minor manipulation of cadaver vessels and pericardial space. Fifty-five medical students in their third year participated in this study. All of the medical students agreed that US could help increase their confidence in performing procedures in the future. Eighty percent (95 % CI 70-91 %) of students felt that there was a benefit of learning ultrasound-based anatomy in addition to traditional methods. Student confidence was self-rated on a five-point Likert scale. Student confidence increased with statistical significance in all of the skills taught. The most dramatic increase was noted in central venous line placement, which improved from 1.95 (SD = 0.11) to 4.2 (SD = 0.09) (p < 0.001). The use of fresh cadavers for procedure-focused US education is a realistic method that improves the confidence of third year medical students in performing complex but critical procedures.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Can Med Educ J
                Journal ID (iso-abbrev): Can Med Educ J
                Journal ID (publisher-id): CMEJ
                Title: Canadian Medical Education Journal
                Publisher: Canadian Medical Education Journal
                ISSN (Electronic): 1923-1202
                Publication date (Electronic preprint): 02 August 2023
                Publication date (Electronic): 30 December 2023
                Publication date Collection: December 2023
                Volume: 14
                Issue: 6
                Pages: 112-113
                Affiliations
                [1 ]Schulich School of Medicine & Dentistry Department of Family Medicine, Western University, Fowler Kennedy Sport Medicine Clinic, Ontario, Canada
                Author notes
                Correspondence to: Jane Thornton; Schulich School of Medicine & Dentistry Department of Family Medicine, Western University, Fowler Kennedy Sport Medicine Clinic, 3M Centre Western University London, ON, Canada N6A 3K7; phone: (519) 661-3011; fax: (519) 661-3379; email: jsthornt@ 123456uwo.ca

                Edited by: Marcel D’Eon (editor-in-chief)

                Article
                Publisher ID: CMEJ-14-112
                DOI: 10.36834/cmej.77293
                PMC ID: 10787854
                PubMed ID: 38226305
                SO-VID: d8f1e980-7afe-4d73-9ed8-010e587c4088
                Copyright © © 2023 Thornton, Mahdi, Schultz, Briscoe; licensee Synergies Partners.
                License:

                This is an Open Journal Systems article distributed under the terms of the Creative Commons Attribution License. ( https://creativecommons.org/licenses/by-nc-nd/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is cited.

                History
                Funding
                Funding
                This study was supported by the Chair’s Research Support Fund, Department of Family Medicine, Western University.
                Categories
                Subject: You Should Try This!

                Data availability:

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