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. 2021 Feb;29(1):18-26.
doi: 10.1177/1742271X20950777. Epub 2020 Sep 1.

Evaluating the effectiveness of a lower extremity venous phantom on developing ultrasound examination skills and confidence

Carol Mitchell  1 , Pazee L Xiong  2   3 , Benjamin L Cox  2   3 , Maame A Adoe  4 , Michelle M Cordio  5   6 , Tonya R Quade  5   6   7 , George Petry  2 , Kevin W Eliceiri  2   3   8
Affiliations

Evaluating the effectiveness of a lower extremity venous phantom on developing ultrasound examination skills and confidence

Carol Mitchell et al. Ultrasound. 2021 Feb.

Abstract

Introduction: The aims of this study were: (1) Determine the effect on student ultrasound scanning skills using a lower extremity venous ultrasound phantom in addition to standard teaching methods of didactic lecture and scanning live volunteers and (2) Determine the effect of using a lower extremity venous ultrasound phantom in addition to standard teaching methods of didactic lecture and scanning live volunteers on student confidence levels in performing the lower extremity venous ultrasound examination.

Methods: Participants were first year diagnostic medical sonography students with minimal scanning experience (n = 11), which were randomized into two groups. Group 1 (n = 5) received the standard didactic lecture and attended a scan lab assessment where they performed a lower extremity venous examination on a human volunteer. Group 2 (n = 6) received the standard didactic lecture, performed three scheduled scanning sessions on an anatomic lower extremity venous phantom with flow and then attended the same scan lab assessment as Group 1, where they performed a lower extremity venous examination on a human volunteer.

Results: Scan lab assessments on day 4 of the study demonstrated a significant difference in scanning performance (p = 0.019) between the two groups. Post scan lab assessment confidence scores also demonstrated a significant difference between how participants in each group scored their confidence levels (p = 0.0260), especially in the ability to image calf veins.

Conclusions: This study suggests anatomical phantoms can be used to develop scanning skills and build confidence in ultrasound imaging of the lower extremity venous structures.

Keywords: Ultrasound; lower extremity venous; phantom; scanning skills.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Financial competing interests: Carol Mitchell: Davies Publishing Inc., authorship textbook. Elsevier, Wolters-Kluwer, author textbook chapters, royalties. Contracted research grants from W.L. Gore & Associates to UW Madison.

Figures

Figure 1.
Figure 1.
Study schedule overview. Participants (N = 11) were randomly selected into two exposure groups, Group 1 (N = 5, no scan lab exposure), and Group 2 (N = 6, scan lab exposure). Both groups underwent the same pre and post knowledge test before and after the didactic lecture.
Figure 2.
Figure 2.
Phantom set up. Water in the reservoir is pumped into the LEV phantom through the micropump and out the distal end back into the reservoir.
Figure 3.
Figure 3.
Transverse views of venous structures without and with compression. (a) The common femoral vein (CFV) and great saphenous vein (GSV). (b) Compression of the CFV and GSV. (c) Confluence of the GSV, deep femoral vein (DFV) and femoral vein (FV). (d) Compression of the GSV, FV, and DFV. (e) Transverse image of the confluence of the popliteal vein (POP V) and anterior tibial vein (ATV). (f) Compression of the POP V and ATV.
Figure 4.
Figure 4.
Longitudinal phantom images demonstrating grayscale, color Doppler, and pulsed wave Doppler (thigh). (a) Longitudinal image of the common femoral vein (CFV) and great saphenous vein (GSV). (b) Color Doppler of the saphenofemoral junction CFV, GSV, and femoral vein (FV). (c) Pulse wave Doppler of the saphenofemoral junction. Flow rates are approximately 10 cm/s, much higher than flow rates in the human body. (d) Longitudinal image of the GSV, FV, and DFV confluence. (e) Color Doppler FV and DFV confluence in the longitudinal plane. (f) Pulse wave Doppler of the FV and DFV confluence in the longitudinal plane. Flow ranges from 0 to 10 cm/s. (g) Longitudinal image FV. (h) Color Doppler imaging of the FV. (i) Pulse wave Doppler of the FV with augmentation.
Figure 5.
Figure 5.
Longitudinal phantom images demonstrating grayscale, color Doppler, and pulsed wave Doppler (calf). (a) Longitudinal image of popliteal vein (POP V) and anterior tibial vein (ATV). (b) Color Doppler of the POP V and ATV. (c) Pulse wave Doppler of the peroneal vein (PERO V). (d) Grayscale image of longitudinal plane of posterior tibial vein (PTV) PERO V confluence. (e) Color Doppler of the PTV–PERO V confluence. PTV modeled reflux. (f) Pulse wave Doppler of the PTV–PERO V confluence. Flow below the baseline demonstrates normal antegrade flow in the vessel color blue. Flow above the baseline demonstrates reflux in the vessel color red.
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