A tissue phantom model for training residents in ultrasound-guided liver biopsy

Rationale and objectives: The apprenticeship model for training of percutaneous liver biopsy has limitations, and costs of commercially available simulation models can be prohibitive. We created an inexpensive tissue phantom for liver biopsy simulation and evaluated the utility of this model for training radiology residents.

Materials and methods: A bovine-porcine tissue phantom was devised as a simulation model and consisted of bovine liver with a porcine rib layer and inserted pimento olives simulating target lesions. Training sessions (a 20-minute didactic lecture and a 90-minute practice session) were offered to all residents in a diagnostic radiology residency. Effect of training was assessed by questionnaire before and after training. Level of knowledge of topics covered in the didactic session, confidence in technical skills, and anxiety level were evaluated on a five-point scale (1, poor to 5, excellent).

Results: Thirty-five of 38 residents received training on the models (~$40). Mean reported value score for training was 4.88/5. Improvement was greatest for knowledge of technique (2.3-4.1/5, P < .001) and knowledge of postprocedure care (2.2-4.1/5, P < .001). Technical confidence increased (2.4-3.8/5, P < .001) and anxiety related to performing liver biopsy improved (2.7-3.7/5, P < .001). Residents with no prior experience in liver biopsy (n = 21) had significantly greater increases in all categories than residents with prior experience (n = 14), except for knowledge about obtaining informed consent and anxiety levels.

Conclusions: Utilization of an inexpensively created bovine/porcine liver biopsy simulation model was well perceived by radiology residents and can be used as an educational tool during residency.