Medical Student Instruction in Peripheral Nerve Blockade Utilizing Fresh Cadaver Limbs in a Simulation Center.

Abstract

Ultrasound imaging is increasingly used in medical practice, but many institutions have room for growth regarding its incorporation into medical education. An elective hands-on course was developed for preclinical medical students using ultrasound to review and enhance their understanding of anatomy as well as to teach ultrasound-guided nerve blocks on cadaver extremities. The hypothesis was that after 3 instructional sessions students would be able to identify 6 anatomic structures, representing 3 types of tissue, in cadaver upper extremities. Students received didactic instruction on ultrasound and regional anatomy at the beginning of each class, followed by hands-on practice, including ultrasound use with phantom task trainers, live models, and fresh cadaver limbs. The primary outcome was the students' ability to correctly identify anatomic structures using ultrasound. Secondary outcomes included their ability to perform a simulated nerve block in the cadaver extremities in comparison with a standardized checklist, as well as their response to a post-course survey. Overall, the students had a 91% success rate in identifying anatomic structures and showed capability of performing simulated nerve block with occasional instructor prompting. The post-course survey revealed that the students felt strongly that both the ultrasound and cadaveric components of the course were beneficial to their education. Ultrasound instruction with live models and fresh cadaver extremities in a medical student elective course resulted in a high degree of recognition of anatomic structures, as well as permitted a valued clinical correlation in the form of simulated peripheral nerve blockade.