A professional training simulator for skill acquisition in ultrasound-guided lumbar facet syndrome intervention:...

Ultrasonography (US) plays a central role in modern diagnostic and interventional medicine, particularly in the management of facet-origin chronic low back pain, a highly prevalent condition in industrialized societies. However, its clinical effectiveness depends largely on the level of specialist training, requiring advanced skills in probe manipulation, sonoanatomy interpretation, brain-hand-eye coordination, and safe planning of interventional procedures. This work presents the development of a training simulator for ultrasound-guided treatment of lumbar facet syndrome; the simulator is implemented within a modular learning framework designed to support the flexible and efficient creation of procedure-specific simulators.

The developed simulator integrates a physical replica of an ultrasound probe, enabling trainees to practice realistic handling. Probe movements performed by the trainee along the scan path are continuously tracked and mapped to corresponding ultrasound images and videos, previously acquired by clinical experts from a real subject and displayed in real time on a computer screen. For interventional planning, a virtual syringe-and-needle component allows trainees to simulate needle orientation and insertion depth, with relevant anatomical structures highlighted as visual learning aids.

A validation study was conducted involving 18 final-year medical students using an ad hoc questionnaire addressing usability, realism, learning support, and overall training experience. The results demonstrate a high level of student acceptance and a positive perceived impact on the acquisition of skills related to ultrasound-guided exploration and interventional planning. Most students reported accelerated skill acquisition in US examination (89% very satisfied, 11% satisfied) and high motivation (83% very satisfied, 17% satisfied). Overall performance and the likelihood of recommending the simulator received the highest rating from all participants (100%).

From the perspective of students, the simulator provides a realistic and supportive learning experience, particularly due to the realism of the physical probe replica, the quality of the graphical user interface, and the guided learning process. From the perspective of instructors, the effectiveness of the simulator depends on the quality of the learning resources and the scope of the training cases. Although the preparation and curation of high-quality ultrasound datasets and annotations remains time-consuming, the framework significantly facilitates and adds flexibility to the development of new case studies. This positions the approach as a valuable complementary training resource, helping to bridge the gap between theoretical instruction and supervised clinical practice in ultrasound-guided procedures.