Abstract
Introduction Ultrasound-guided peripheral nerve blocks (USGPNB) are performed by various specialists and are excellent, non-addicting pain control techniques. Alternative pain management approaches are needed to combat opiate abuse. Medical students should be aware of alternative pain management therapies before they begin clinical practice.Objective Our objective was to determine if medical students can identify peripheral nerves under ultrasound and perform a USGPNB after a one-day hands-on training session.Methods This was a cross-sectional study at an academic medical center. The study participants were third-year medical students with minimal prior ultrasound experience. Students were given an introductory lecture highlighting the opiate epidemic and benefits of USGPNB prior to the workshop. The one-day hands-on educational workshop consisted of learning basic sonographic anatomy, indications for USGPNB, and practicing needle guidance under ultrasound guidance. After the educational workshop, students’ procedural competency was assessed by ultrasound-trained emergency medicine clinicians.Results A total of 94 participants were included in this study. The average pre-test score was 68.4% (95% confidence interval [CI]; 65.4% to 71.4%). After the one-day educational workshop, the post-test score was 92.8% (95% CI; 90.8% to 94.8%). The average hands-on evaluation score was 84.4% (95% CI; 81.6% to 87.3%). All students agreed that this educational session is a good start to learning about USGPNB, and they felt comfortable identifying the peripheral nerves using ultrasound. On a confidence scale of one (low) through 10 (high), 83% (95% CI; 75.9% to 90.15%) rated their confidence as ≥6. All except one student either agreed that this educational session helped them understand how USGPNB could be integrated into acute pain management. The majority (84% [95% CI; 77% to 91%]) agreed that the session will change how they manage patients’ acute pain in their future medical practice.Conclusion Medical students can learn the sonographic anatomy of peripheral nerves and techniques of USGPNB after a one-day educational session.
Highlights
Ultrasound-guided peripheral nerve blocks (USGPNB) are performed by various specialists and are excellent, non-addicting pain control techniques
Medical students should be aware of alternative pain management therapies before they begin clinical practice
Our objective was to determine if medical students can identify peripheral nerves under ultrasound and perform a USGPNB after a one-day hands-on training session
Summary
Probes and Knobology: -Explain the differences between the various probes -Know the use of a linear probe for nerve blocks -Learn the Optimize button function -When/how color Doppler is usedUpper extremity nerves: -Identify the median, radial, and ulnar nerves -Find nerves’ neighboring arteries -Demonstrate anisotropy in nerves -Identify tendons and nerves -Describe differences between tendons and nerves -Know nerve sensory distributionsLower extremity nerves: -Identify femoral nerve and sciatic nerve -Identify branches of the sciatic nerves -Identify veins vs arteries with compression -Identify veins vs arteries with color Doppler -Identify neurovascular bundle in femoral area -Identify the neurovascular bundle in the popliteal area -Know nerve sensory distributionsNerve block phantom (~45 minutes for practice): -Identify the supplies needed for the procedure -Visualize needle under ultrasound in the long axisAssessment session – 1.2 hoursHands-on evaluation (live model and phantom) Completion of post-test and exit surveyStatistical analysisDescriptive statistics were used to analyze the data. Probes and Knobology: -Explain the differences between the various probes -Know the use of a linear probe for nerve blocks -Learn the Optimize button function -When/how color Doppler is used. Lower extremity nerves: -Identify femoral nerve and sciatic nerve -Identify branches of the sciatic nerves -Identify veins vs arteries with compression -Identify veins vs arteries with color Doppler -Identify neurovascular bundle in femoral area -Identify the neurovascular bundle in the popliteal area -Know nerve sensory distributions. Hands-on evaluation (live model and phantom) Completion of post-test and exit survey. A total of 94 participants were included in the data analysis for the assessments and hands-on session evaluation. The average pre-test score was 68.4% (95% confidence interval [CI]; 65.4% to 71.4%).
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