PD4-06 A RANDOMIZED CONTROL TRIAL DEMONSTRATES THAT ULTRASOUND-GUIDED PERCUTANEOUS RENAL ACCESS IS A TEACHABLE SKILL.

Abstract

You have accessJournal of UrologyImaging/Radiology: Uroradiology I1 Apr 2015PD4-06 A RANDOMIZED CONTROL TRIAL DEMONSTRATES THAT ULTRASOUND-GUIDED PERCUTANEOUS RENAL ACCESS IS A TEACHABLE SKILL. Pauline Filippou, Anobel Odisho, Krishna Ramaswamy, Weiguo Hu, Jianxing Li, and Thomas Chi Pauline FilippouPauline Filippou More articles by this author , Anobel OdishoAnobel Odisho More articles by this author , Krishna RamaswamyKrishna Ramaswamy More articles by this author , Weiguo HuWeiguo Hu More articles by this author , Jianxing LiJianxing Li More articles by this author , and Thomas ChiThomas Chi More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.318AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Ultrasound (US)-guided percutaneous renal access minimizes radiation exposure, but is not widely performed by urologists in the United States. Urologic trainees acquire varying amounts of US experience. This randomized control trial evaluates the effect of a hands-on US training session on US-guided percutaneous needle placement accuracy. METHODS PGY1-6 trainees of the UCSF urology residency program were randomized intro three groups. All groups completed a time trial of placing a needle into a modeled target under US guidance. Group 1's time trial occurred prior to any training, group 2's after experiencing a hands-on training module, and group 3's after exposure to both the training module and 1-on-1 attending feedback. Time until needle placement, number of repositioning attempts and needle placement accuracy were measured. A confidence survey was taken before and after module exposure. Statistical analyses were performed using Student's t tests. RESULTS Seven trainees were randomized to group 1, three to group 2 and five to group 3. All residents reported minimal prior US training. Overall confidence scores (scale: 1–40; 40 most confident) improved significantly after completing the training module (16.8 before vs. 25.1 after, p<0.01). This improvement was most significant in PGY1-3 residents (12.1 vs. 21.1, p<0.01). Time to needle placement was fastest and most accurate after attending feedback in group 3 (46.6 sec in group 1 vs. 82.4 sec in groups 2 and 3, p<0.01; 80% accuracy in group 1 vs 38% accuracy in groups 2 and 3, p<0.01). Number of repositioning attempts did not differ significantly between the three groups. CONCLUSIONS Hands-on training modules increased resident confidence in their use of US-guided needle placement for percutaneous renal access. However, attending teaching and feedback is critical for improving accuracy in guiding a needle toward its intended target. Short, formalized training sessions in US use can be readily implemented in urologic training to improve resident skill and confidence. US-guided percutaneous renal access is a teachable, achievable skill. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e88-e89 Peer Review Report Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Pauline Filippou More articles by this author Anobel Odisho More articles by this author Krishna Ramaswamy More articles by this author Weiguo Hu More articles by this author Jianxing Li More articles by this author Thomas Chi More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...