Training Physician Assistant Students in Ultrasound-Guided Knee Arthrocentesis Using Formalin-Embalmed Cadavers.

Abstract

Introduction: The quantity of ultrasound-guided procedures performed by physician assistants and other advanced practice providers has increased substantially in recent years. Simulation models that balance anatomical realism, cost, and accessibility are needed to allow physician assistant (PA) students to develop the critical tactile skills necessary to perform procedures under ultrasound guidance in a safe and stress-free learning environment.

Methods: Twenty-four PA student participants watched a brief orientation training video and then received 20 minutes of one-on-one instruction on performing ultrasound-guided knee arthrocentesis using a formalin-embalmed cadaver. Participants were given pretraining and post-training self-confidence surveys and were objectively evaluated with a procedural skills assessment following cadaveric simulation training.

Results: Twenty-one of the 24 participants passed the skills assessment by successfully using ultrasound guidance to aspirate 1 mL of fluid from an artificial effusion in a cadaveric knee within the 5-minute time limit. Successful participants needed an average of 2.25 attempts (needle sticks) and 121.8 seconds to successfully complete the procedure. Participant self-confidence increased significantly following training across all surveyed items.

Discussion: Artificial knee effusions can be easily created in formalin-embalmed cadavers. These make excellent simulation training models to teach PA students to perform ultrasound-guided knee arthrocentesis. Following brief simulation training with formalin-embalmed cadaver knees, PA students can significantly increase their self-confidence in their procedure-related abilities, and they can objectively perform the procedure quickly and accurately.