Physician Assistant Student Simulation Training in Ultrasound-Guided Procedures Using Synthetic Cysts and Formalin-Embalmed Cadavers

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INTRODUCTION: Traditionally, if ultrasound needle-guidance training is included in physician assistant (PA) education it occurs during the clinical year and uses live patients at the bedside. This practice requires learning a highly tactile skill in a high-stress learning environment where mistakes during the learning process will likely result directly in patient discomfort or complication-related injury. Simulation training with formalin-embalmed cadavers can provide realistic training opportunities with no risk to patients. This study examines the effectiveness of integrating simulation training in ultrasound-guided percutaneous cyst drainage into PA education. METHODS: Thirty-seven PA student participants engaged in training activities to learn to use ultrasound to access and drain synthetic cysts embedded within cadaver tissue. Participants were assessed using pre-training and post-training self-confidence questionnaires and objective skills examinations administered by an instructor. RESULTS: Participant self-confidence related to all assessed aspects of performing the procedure significantly increased after training ( P < 0.0001). Only 2 participants were unable to successfully pass the skills assessment. Participants required 1.9 needle sticks on average to complete the procedure successfully in an average time of 143 seconds. DISCUSSION: Simulation training using synthetic cysts and formalin-embalmed cadavers provides PA students with a realistic and low-stress learning environment in which to develop the complex tactile skills needed to successfully guide a needle with ultrasound while performing a clinical procedure. Training sessions like this should be integrated into PA education to allow students to safely develop the skills and confidence they need to perform ultrasound-guided procedures on live patients and minimize risk of adverse outcomes.