Dataset Information

New Ultrasound Technology Is a Useful Training Adjunct for Invasive Procedures.

ABSTRACT:

Background

The use of ultrasound for procedural guidance is an essential skill in emergency medicine (EM) and a required Accreditation Council for Graduate Medical Education (ACGME) competency for residents. Resident learners develop their skill set through hands-on training and may benefit from an intervention that encourages proper technique, bolsters confidence, and improves procedural success. Clear Guide ONE, a Food and Drug Administration-approved technology, overlays real-time virtual instrument navigation onto ultrasound displays to allow visualization of expected instrument trajectory prior to needle puncture, ensuring alignment with the target.

Objectives

This study investigated computer-assisted instrument guidance as an educational tool for residents in a simulation environment. Primarily, the study evaluated residents' procedural speed and accuracy using ultrasound with and without the guidance device.

Methods

A total of 34 residents were observed performing ultrasound-guided needle placement in ballistic gel models with and without computer assistance in a simulation-based observational crossover study. Scan time before needle insertion, time to target, total procedure time, number of needle redirections, and procedural accuracy were measured. A total of 104 observations were recorded with 52 in each group. Paired-sample t-test analysis was used to compare group performance. Secondary outcomes were derived from survey data assessing resident opinions about the device.

Results

The computer-guidance group significantly outperformed the ultrasound-alone group in mean time to target, number of needle redirections, and procedural accuracy. There was no significant difference in mean scan time before needle insertion or total procedure time. Fifty percent of residents preferred the guidance system. Most residents (67%, n = 23) reported that the device increased confidence and the majority (94%, n = 32) reported perceived improvement in speed, accuracy, or both.

Conclusions

Use of computer assistance technology for sonographic instrument guidance was successful in improving procedural accuracy, number of needle redirections, and time to target performance metrics and was well received by residents. This educational study suggests that this technology may emerge as a valuable tool in training EM residents to utilize ultrasound for procedures.

SUBMITTER: Wilson CL

PROVIDER: S-EPMC6001741 | biostudies-literature | 2017 Oct

REPOSITORIES: biostudies-literature

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Publications

New Ultrasound Technology Is a Useful Training Adjunct for Invasive Procedures.

Wilson Casey Lee CL Keefe Devin D Ehmann Michael R MR

AEM education and training 20170906 4

<h4>Background</h4>The use of ultrasound for procedural guidance is an essential skill in emergency medicine (EM) and a required Accreditation Council for Graduate Medical Education (ACGME) competency for residents. Resident learners develop their skill set through hands-on training and may benefit from an intervention that encourages proper technique, bolsters confidence, and improves procedural success. Clear Guide ONE, a Food and Drug Administration-approved technology, overlays real-time vir ...[more]

PMID: 30051056

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Project description:ObjectivesEye-tracking technology has emerged as a potentially useful learner assessment tool in several medical specialties. In the fields of general surgery and anesthesiology, it has been shown to reliably differentiate between different levels of expertise in procedural skills. In the field of radiology, it has been shown to be a valid assessment tool for diagnostic test interpretation. Current methods of competency assessment in point-of-care ultrasound (POCUS) remain a challenge, because they require significant direct observation time by an instructor. The purpose of this study was to determine if eye-tracking technology can accurately distinguish between novice and experts in the interpretation of POCUS clips, specifically of the focused assessment using sonography in trauma (FAST) scan.MethodsA convenience sample of medical students, residents, and emergency physicians from a single academic emergency department were invited to participate. Participants included both novices and experts in POCUS. Each participant completed a baseline questionnaire and viewed 16 video clips of a FAST ultrasound examination while their gaze patterns were recorded by a commercially available eye-tracking device. The primary outcome was total gaze time on the area of interest (AOI). Secondary outcomes included total time to fixation, mean number of fixations, and mean duration of first fixation on the AOI.ResultsFifteen novices and 15 experts completed this study. For total gaze time on the AOI, experts fixated their gaze significantly longer than novices (75.8 ± 16.2 seconds vs. 56.6 ± 12.8 seconds, p = 0.001). Similarly, experts were significantly faster to fixate on the AOI and had a higher fixation count on the AOI (8.5 ± 4.0 seconds vs. 15.1 ± 6.8 seconds, p = 0.003; and 170 ± 30 vs. 143 ± 28 seconds, p = 0.016). There were no differences on the mean duration of first fixation on the AOI (0.42 ± 0.12 seconds vs. 0.39 ± 0.09 seconds, p = 0.467).ConclusionEye-tracking technology shows the potential to differentiate between experts and novices by their gaze patterns on video clips of FAST examinations. The total gaze time on the AOI may be a useful metric to help in the assessment of competency in POCUS image interpretation. In addition, the evaluation of gaze patterns may help educators identify causes of interpretation errors. Future studies are needed to further validate these metrics in a larger cohort.

Project description:PurposePosterior plagiocephaly (PP) is a common clinical condition in pediatric age. There are two main causes of PP: postural plagiocephaly and craniosynostosis. Early diagnosis is important, as it prevents neurological complications and emergencies. Diagnosis in the past was often made late and with imaging tests that subjected the infant to a high radiation load. Suture ultrasound does not use ionizing radiation; it is easy to perform, allows an early diagnosis, and directs toward the execution of the cranial 3D-CT scan, neurosurgical consultation, and possible intervention. The aim of the study is to describe the high sensitivity and specificity of suture ultrasound for the differential diagnosis between plagiocephaly and craniosynostosis.MethodsWe reported our prospective experience and compared it with the data in the literature through a systematic review. The systematic review was conducted on electronic medical databases (PubMed, Embase, Cochrane Library, Scopus, and Web of Science) evaluating the published literature up to November 2020. According to Preferred Reporting Items for Systematic Reviews and Meta-ANALYSES (PRISMA statement), we identified 2 eligible studies. Additionally, according to AMSTAR 2, all included reviews have been critically rated as high quality. A total of 120 infants with abnormal skull shape were examined in NICU. All underwent clinical and ultrasound examination.ResultsOf the total, 105 (87.5%) had plagiocephaly and 15 dolichocephaly/scaphocephaly (12.5%). None of these had associated other types of malformations and/or neurological disorders. The synostotic suture was identified ultrasonographically in 1 infant and subsequently confirmed by 3D CT scan (100%).ConclusionCranial sutures ultrasonography can be considered in infants a selective, excellent screening method for the evaluation of skull shape deformities as first technique before the 3D CT scan exam and subsequent neurosurgical evaluation. Cranial suture ultrasonography should be considered part of clinical practice especially for pediatricians.

Dataset Information

New Ultrasound Technology Is a Useful Training Adjunct for Invasive Procedures.

Background

Objectives

Methods

Results

Conclusions

Publications

New Ultrasound Technology Is a Useful Training Adjunct for Invasive Procedures.

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