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Agar-Gelatin Phantom Model for Teaching Ultrasound Guided Injections

Jared B. Gilman, MD (Virginia Commonwealth University Health System PM&R Program, Richmond, United States); Allison Hickman

Meeting: AAPM&R Annual Assembly 2019

Session Information

Date: Thursday, November 14, 2019

Session Title: Musculoskeletal and Sports Medicine Research Report

Session Time: 12:30pm-2:00pm

Location: Research Hub - Kiosk 8

Disclosures: Jared B. Gilman, MD: Nothing to disclose

Objective: The use of ultrasound (US) to guide peripheral (and some axial) musculoskeletal (MSK) interventions is rapidly gaining acceptance as an efficient and precise tool for guided injection procedures. However, there are challenges to using ultrasound to guide these injections. Traditional procedural education is often based on observation followed by supervised performance until proficiency is achieved. Though effective, this can expose patients to less experienced providers, with potential impact on patient comfort, safety and efficacy of the injection procedure.

Design: Experimental objects were embedded in the gelatin-agar phantom model such as pencil erasers, wine corks, or plastic straws allowing for ’target practice.’ Five PM&R residents with limited to no ultrasound experience participated in this trial. Each resident took a pre and post workshop self-assessment survey and used the agar-gelatin model with a small target suspended in the gel at ~1-2cm depth.

Setting: Ultrasound/MSK lecture series

Participants: PM&R residents

Interventions: Pre and post workshop self-assessment survey based on a modified global rating scale (GRS, scale 1-7). Each participant underwent a pre workshop US guided injection test for 5 minutes with the overall goal to hit the ‘target’ as many times as possible.

Main Outcome Measures: The goal is proof of concept in improving user comfort with ultrasound and ultrasound guided injections by using gelatin-agar phantom model.

Results: For the five participants, mean GRS for comfort using an ultrasound machine increased from 3.4 to 5.2 after the workshop. Mean GRS for comfort interpreting an ultrasound image increased from 3.2 to 4.8. Mean GRS for comfort performing an ultrasound guided injection improved from 2.4 to 4.8.

Conclusions: A low cost, modifiable, re-usable ultrasound ‘phantom’ was created and was able to simulate a needle passing through ‘tissue’ and hitting a target. Trainees were able to use this model to practice US technique and gain confidence in a low stress and no harm environment.

Level of Evidence: Level IV

To cite this abstract in AMA style:

Gilman JB, Hickman A. Agar-Gelatin Phantom Model for Teaching Ultrasound Guided Injections [abstract]. PM R. 2019; 11(S2)(suppl 2). https://pmrjabstracts.org/abstract/agar-gelatin-phantom-model-for-teaching-ultrasound-guided-injections/. Accessed May 22, 2025.
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