Building ultrasound-guided procedure skills in regional anesthesiology: simulation training with a formalin-embalmed...

The use of ultrasound guidance in regional anesthesiology procedures has become the standard of care. Using ultrasound to guide a needle is a highly technical skill that requires deliberate training and repetitive hands-on practice to master. Cost effective and anatomically realistic simulation training opportunities are needed to allow medical trainees to develop these skills prior to performing procedures on patients. Simulation training with formalin-embalmed cadavers, which are the most widely available type of body donor, may provide appropriate and effective needle-guidance training opportunities without risk to patients.

Nineteen first-year medical students viewed an orientation video and attended a femoral nerve block simulation training workshop using formalin-embalmed cadavers. Participants received 20-minutes of one-on-one training, followed by a 5-minute skills test. Pre- and post-training surveys were also conducted.

Participant self-confidence in their ability to perform all aspects of the procedure increased significantly following training (p = < 0.001). During the skills assessment, all participants but one were able to independently guide their needle into the target zone for a femoral nerve block in an average of 106 s. Participants needed an average of 1.9 attempts to complete the procedure. Ultrasound images of formalin-embalmed tissue were clear and relevant structures were easy to visualize during needle guidance.

Brief simulation training with formalin-embalmed cadavers can effectively allow novice medical trainees to build and demonstrate the crucial skills needed to accurately guide a needle with ultrasound in regional anesthesiology procedures. This type of training is anatomically accurate and allows for low-stakes repeated practice without any risk to patients during the learning process.