Critical Care Explorations (Apr 2022)

Advancing Point-of-Care Ultrasound Training in Medical Schools: Ultrasound-Guided Subclavian Vein Access Training Using Formalin-Embalmed Cadavers

  • Bosten A. Loveless, BS,
  • Maxton W. Muir, BA,
  • Abigail L. Limov, BS,
  • Alexa R. Fritsch, BS,
  • Rebecca J. Thomas, BS,
  • Taylor J. Yancey, BS,
  • Chad J. Skidmore, BS,
  • Isain Zapata, PhD,
  • Andrew D. Nigh, MD,
  • Nena Lundgreen Mason, PhD

DOI
https://doi.org/10.1097/CCE.0000000000000680
Journal volume & issue
Vol. 4, no. 4
p. e0680

Abstract

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OBJECTIVES:. This brief report examines the feasibility of using formalin-embalmed cadavers in training medical students to use ultrasound guidance to access the subclavian. This novel educational approach is discussed in the context of the ongoing integration of point-of-care ultrasound training into medical education. Additionally, this report explores how cadavers can provide practical, effective, and hands-on skills training opportunities for medical students to learn to perform common clinical procedures under ultrasound guidance. DESIGN:. This report presents subjective and objective data evaluating the utility of teaching medical students to perform ultrasound-guided subclavian vein access on formalin-embalmed cadavers. SETTING:. Rocky Vista University College of Osteopathic Medicine in Ivins, UT. SUBJECTS:. Twenty-five first-year medical students at Rocky Vista University. INTERVENTIONS:. None. MEASUREMENTS AND MAIN RESULTS:. Pre and posttraining questionnaires were administered to assess each participant’s self-confidence in using ultrasonography to access the subclavian vein of a cadaver. A statistically significant increase in participant self-confidence was observed across all questionnaire items from pre to posttraining. Objective evaluation consisted of a supervised skills test. Participants were evaluated on their ability to visualize the subclavian vein with ultrasound and achieve flashback of blood/embalming fluid into a syringe. During skills testing, the number of needle sticks and the time taken to achieve flashback were recorded for each participant. Twenty-three of the 25 participants were able to successfully complete the skills testing assessment. CONCLUSIONS:. The formalin-embalmed cadaver can be a readily available and effective learning tool for medical education programs seeking to provide training opportunities in ultrasound-guided clinical procedures. The use of cadavers allows learners to train in a low stress and anatomically authentic environment without risk of patient discomfort.