Comparison of Commercial Versus Homemade Models for Teaching Ultrasound-Guided Peripheral I.V. Placement

Abstract

BackgroundVarious commercially available and do-it-yourself (DIY) models are used to teach emergency medicine (EM) residents and medical students ultrasound (US)-guided i.v. insertion. Expensive commercial models degrade over time, but DIY models are inexpensive, easily prepared, and readily discarded. ObjectiveWe tested the hypothesis that DIY models are equally effective as commercial models for teaching US-guided i.v. insertion, and using a controlled trial to subjectively evaluate how well DIY models and commercially manufactured models compare with human tissue both tactilely and sonographically. MethodsWe tested three models for US-guided i.v. teaching—a commercially available model US training block model, a homemade tofu model, and a homemade gelatin model. All three models were compared with US-guided i.v. insertion involving human tissue. Study participants were EM residents and EM attendings experienced in US-guided i.v. placement in real patients. After practicing peripheral i.v. placement under US guidance using the three media, participants at various levels of training and experience with US-guided i.v. insertion subjectively described how each media compared tactilely and sonographically, which model was most similar to a live human overall, and which model was best for instructing learners. ResultsThe overall score (sum of visual and sonographic scores) for the gelatin model was significantly higher than either of the other models, indicating that the gelatin model was evaluated as most approximate to the anatomy of a human compared with the other models. ConclusionsInexpensive homemade alternatives to commercial simulators can be realistic and effective surrogates for learning US-guided peripheral i.v. placement.