Integrating Donor Dissection, Simulation and Live Ultrasound, of the Femoral Region During an Anatomy Lab

Course Enables First Year Medical Students to Conduct Femoral Nerve Blocks

MINA, Adam1 and Brion BENNINGER1-10. Anatomy Center for Innovative Education and Science1,

Departments of Medical Anatomical Sciences2, Neuromuscular Medicine3, Family Practice4, Western University of Health Sciences, COMP–Northwest, Lebanon, OR. USA. Faculty, College of Dental Medicine5, Pomona CA. Departments of Orthopaedics6 and General Surgery7, Samaritan

Health Services, Corvallis, OR. USA. Departments of Oral Maxillofacial Surgery8, Surgery9, Orthopaedics & Rehabilitation10, Oregon Health & Science University, Portland, OR. USA.

The Anatomy Center at COMP-NW lab emphasizes clinical anatomy starting in the first year of medical education

OBJECTIVE Ultrasound simulation: introducing an intermediate learning modality between anatomy and live ultrasound during an anatomy course INTRODUCTION • Ultrasound is the visual stethoscope of the future • Ultrasound can be daunting to students during anatomy • Use of a simulator could be a useful medium for learning

ultrasound

METHODS

Ultrasound simulator utilized during instruction of the femoral triangle anatomy

Basic ultrasound instruction

Donor cadaver patient dissection

Ultrasound simulator workshop

Simulator practice

Live ultrasound simulator workshop

Anatomy didactic Integrated Anatomy - Ultrasound Curriculum Overview

Live ultrasound practice

Didactic and laboratory examination including simulated and live ultrasound

Student feedback

Femoral triangle anatomy review Anatomy – Simulator – Ultrasound - Anatomy

Remember NAVEL (Nerve Artery Vein Empty Lymphatic) What is the ACTUAL position of the femoral nerve? Image: Netter (2011)

Student performing simulated ultrasound guided femoral nerve block

Touch of Life Technologies OPUS mini www.toltech.net

Using femoral nerve block simulation to prepare students for live ultrasound

Ultrasound Simulator Live Ultrasound

V A N

I

P

Medial Lateral

Sonosite M-Turbo

Student performance and feedback using an ultrasound simulator • Students could successfully identify contents of the femoral triangle and

introduce the simulated needle to the area of the nerve • Following simulation, students could perform live ultrasound of the femoral

region

• The ultrasound simulator was useful in the students’ focus of cadaveric dissection regarding the femoral triangle

• A majority of students reported that the simulation eased their learning of live ultrasound

• Students recommend that ultrasound simulation be integrated into the anatomy course

2

9

3

2

0 1 2 3 4 5 6 7 8 9 10

NOT HELPFUL

SOMEWHAT HELPFUL

MODERATELY HELPFUL

VERY HELPFUL

Did use of the simulator help the students' focus of cadaver dissection regarding the femoral triangle?

13

2

1

0 2 4 6 8 10 12 14

ULTRASOUND SIMULATOR

LIVE ULTRASOUND

NO EXPERIENCE

Which modality was easier for students to use in locating the femoral nerve?

15

1

0 2 4 6 8 10 12 14 16

YES

NO

Would students recommend that ultrasound simulation be integrated into the anatomy course?

CONCLUSION This pilot study revealed that the chronologic integration of • Donor cadaver dissection • Ultrasound simulation • Live ultrasound • Active formal examination is a successful teaching methodology for femoral triangle anatomy and ultrasound skills. Next step is to introduce the ultrasound simulator to the fall anatomy class of over 100 first year medical students

Thank You

• Stephanie Duckett • Jonathan Shader • Students & Faculty of the 2013

Intensive Summer Anatomy Course • COMP & COMP-NW • OPSO

Photography contribution • Matthew Casper • Luke Rauch

• Intro slide: Gray (1918)

Questions?