BACKGROUND: Good hand-eye coordination is a prerequisite for safe ultrasound-guided peripheral nerve blocks. However, new skills have to be acquired when compared to the traditional nerve stimulation technique. We tested and mathematically described the learning curve of these skills in inexperienced ultrasound users employing a simple phantom of a peripheral nerve. METHODS: A simple phantom made from a piece of spaghetti to simulate a nerve, within a starch core and embedded in gelatine was used for ultrasound-guided simulation of a peripheral nerve block. Eighteen medical students who were novices to ultrasound were enrolled. Serial time to successful injection was measured. Quality of injection was rated by two independent observers. RESULTS: Time to successful injection improved from a median of 66.5 s (49.5-90) for the first trial to 37 s (23.5-53.5) for the 11th trial. A plateau of 30 s was reached for t 1/2 after 2.7 trials and 4 × t 1/2 after 7.8 trials when described as first-order exponential decay. Time to successful injection was significantly shortened after 5 trials. Quality of injection with numbers of trials followed a sigmoidal shape with 50 % of maximum quality after 3.6 trials and a plateau after 8.5 trials. Likewise, a significant improved quality of injection was reached after 5 trials. CONCLUSION: Based on our mathematical analyses of the learning curve, inexperienced ultrasound users can improve their hand-eye coordination within 5 subsequent trials in a simple model of a peripheral nerve block.
BACKGROUND: Good hand-eye coordination is a prerequisite for safe ultrasound-guided peripheral nerve blocks. However, new skills have to be acquired when compared to the traditional nerve stimulation technique. We tested and mathematically described the learning curve of these skills in inexperienced ultrasound users employing a simple phantom of a peripheral nerve. METHODS: A simple phantom made from a piece of spaghetti to simulate a nerve, within a starch core and embedded in gelatine was used for ultrasound-guided simulation of a peripheral nerve block. Eighteen medical students who were novices to ultrasound were enrolled. Serial time to successful injection was measured. Quality of injection was rated by two independent observers. RESULTS: Time to successful injection improved from a median of 66.5 s (49.5-90) for the first trial to 37 s (23.5-53.5) for the 11th trial. A plateau of 30 s was reached for t 1/2 after 2.7 trials and 4 × t 1/2 after 7.8 trials when described as first-order exponential decay. Time to successful injection was significantly shortened after 5 trials. Quality of injection with numbers of trials followed a sigmoidal shape with 50 % of maximum quality after 3.6 trials and a plateau after 8.5 trials. Likewise, a significant improved quality of injection was reached after 5 trials. CONCLUSION: Based on our mathematical analyses of the learning curve, inexperienced ultrasound users can improve their hand-eye coordination within 5 subsequent trials in a simple model of a peripheral nerve block.
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Authors: Richard A Hoppmann; Jeanette Mladenovic; Lawrence Melniker; Radu Badea; Michael Blaivas; Miguel Montorfano; Alfred Abuhamad; Vicki Noble; Arif Hussain; Gregor Prosen; Tomás Villen; Gabriele Via; Ramon Nogue; Craig Goodmurphy; Marcus Bastos; G Stephen Nace; Giovanni Volpicelli; Richard J Wakefield; Steve Wilson; Anjali Bhagra; Jongyeol Kim; David Bahner; Chris Fox; Ruth Riley; Peter Steinmetz; Bret P Nelson; John Pellerito; Levon N Nazarian; L Britt Wilson; Irene W Y Ma; David Amponsah; Keith R Barron; Renee K Dversdal; Mike Wagner; Anthony J Dean; David Tierney; James W Tsung; Paula Nocera; José Pazeli; Rachel Liu; Susanna Price; Luca Neri; Barbara Piccirillo; Adi Osman; Vaughan Lee; Nitha Naqvi; Tomislav Petrovic; Paul Bornemann; Maxime Valois; Jean-Francoise Lanctot; Robert Haddad; Deepak Govil; Laura A Hurtado; Vi Am Dinh; Robert M DePhilip; Beatrice Hoffmann; Resa E Lewiss; Nayana A Parange; Akira Nishisaki; Stephanie J Doniger; Paul Dallas; Kevin Bergman; J Oscar Barahona; Ximena Wortsman; R Stephen Smith; Craig A Sisson; James Palma; Mike Mallin; Liju Ahmed; Hassan Mustafa Journal: Ultrasound J Date: 2022-07-27