Improving clinician performance in ultrasound-guided thyroid FNA: a simulation-based training intervention with a custom phantom

Purpose: Ultrasound (US)-guided fine needle aspiration (FNA) is essential for evaluating indeterminate thyroid nodules. Limited hands-on opportunities for trainees and reliance upon senior supervision are barriers for traditional training methods. With a shift towards simulation-based educaday course was designed where participants received didactic teaching andtion (SBE) to overcome the steep learning curve of this procedure we evaluated the inclusion of a novel interventional neck phantom into a short US training course (to increase clinician confidence and competence). Methods: A two-day course was designed where participants received didactic teaching and SBE on each day respectively. Participants were asked to complete an assessed FNA on the simulation phantom at the end of each day and complete a survey on their confidence and satisfaction. Assessment was carried out by Radiology residents using structured criteria and the results were compared before and after SBE. Results: Twenty-five participants took part in the study, procedural scores (max 30) increased from a mean of 11.92 on day one to 22.32 on day two(p < 0.001). This improvement was significant in all domains (p < 0.01): applied knowledge of US equipment (2.72 to 3.88), image optimization (1.88 to 3.36), and systematic examination (2.48 to 3.60) FNA performance (5.64 on 11.48). Participant confidence in performing the procedure increased from 16% on day one to 80% on day two, and over 90% felt that the simulation phantom was straightforward to use and enhanced their practical skills. Conclusion: An US course incorporating SBE (with a novel FNA phantom) significantly improves clinician competency and confidence in performing US-guided FNA, addressing the need for improved training in this procedure.