3:45 PM Abstract No. 297 Custom 3D-printed ultrasound-compatible vascular access models: training medical students for vascular access

Abstract

Commercially available US-guided vascular access models (CM) simulate anatomic and US-visible landmarks; however, they are expensive and do not simulate variant anatomy. The purpose of this study was to compare training efficacy between CM and a novel 3D-printed US-compatible vascular access model (3DPVAM) using a simulation experience (SE) directed at medical students. We hypothesized that student comfort with US-guided femoral artery (FA) access increases after SE, and that 3DPVAM and CM SE efficacy are comparable. A 3DPVAM of normal FA anatomy was developed from an anonymized CT exam. After IRB approval, students were randomized to 3DPVAM or FemoraLineMan CM (Simulab) SE. Students completed a pre-SE questionnaire ranking comfort with FA access on a Likert scale. A standardized SE was administered by IR faculty. Students completed a post-SE questionnaire ranking comfort with FA access on a Likert scale. Student questionnaire results were compared between 3DPVAM and CM groups using Chi-square, Wilcoxon signed-rank, and noninferiority analyses. 15 and 17 students were randomized to 3DPVAM and CM training, respectively. 93.3% of 3DPVAM trainees and 100% of CM trainees had never attempted FA access. 73.3% of 3DPVAM trainees and 76.5% of CM trainees did not feel confident performing FA access. After training and SE, most 3DPVAM and CM trainees agreed that the model was easy to use (93.3% and 94.1%, respectively) and helpful for practice (93.3% and 94.1%). In both groups, training increased subjective student confidence by 2 Likert points (3DPVAM p = 0.001; CM p = <0.0001). The subjective confidence increase in 3DPVAM trainees was noninferior to that in CM trainees (noninferiority margin 1 Likert point, p<0.0001). Generation of an inexpensive custom 3DPVAM and SE is feasible and produces comparable subjective training outcomes to CM. We aim to extend our SE to resident and fellow trainees and to assess objective improvements in the future. We also aim to develop complex 3DPVAMs of variant anatomy and other body regions with the goal of creating customizable models to improve vascular access outcomes and patient safety across multiple disciplines.