Cutting to the Chase: Sectioned Plastinated Heart Models Improved Performance and Confidence in Cardiac Ultrasound
Authors: Royer Danielle , Harvey Tawnya , Gritton Cory Buenting 
Published: April 2020

At the University of Colorado School of Medicine, hands‐on ultrasound (US) labs are incorporated into medical and graduate gross anatomy courses. In regional US labs, students perform live US scanning to learn the basics of a clinical skill and image interpretation, while reviewing key anatomy concepts. Cardiac US scanning is particularly challenging due to heart position in the thorax, and standard US views (parasternal long axis/PLAX and parasternal short axis/PSAX) differing from typical imaging and dissection views. The study aimed to evaluate 3D plastinated heart models sectioned in PLAX & PSAX views as resources during novice US training.

In an IRB exempt study, eight plastinated human hearts were sectioned along standard US views (4 PLAX, 4 PSAX) creating 3D‐sectioned models. Graduate gross anatomy students (N=25) were recruited during a scheduled cardiac US lab. Small groups performed cardiac scanning for 50 minutes with instructions and PLAX/PSAX views handout. Students then received a survey with 7 Likert questions of self‐confidence in heart position, PLAX and PSAX probe orientation, and anatomical structure recall and identification. Students were assessed on 8 multiple choice questions (MCQ) categorized as Anatomical Identification (N=2), US View Identification (N=3), or Combined US & Anatomy (N=3). Next, groups received a PLAX‐sectioned heart model with repeat PLAX/PSAX scanning instructions and views handout. After 20 minutes scanning with models, students received another Likert survey (2 repeat self‐confidence items & 9 items on 3D‐sectioned heart models as aides) and MCQ quiz of 8‐items matched to pre‐quiz. Due to time, PSAX‐sectioned models were not provided.

Participant responses (n=25, 100% response rate) showed PLAX‐sectioned models perceived useful for learning PLAX US (100% agreement; ratings 4 or 5) and sectioned heart models would be useful in learning PSAX (96% agreement). Self‐perceived confidence in PLAX and PSAX probe orientation significantly improved after PLAX‐sectioned model use (Mann‐Whitney U Tests, both p<0.05). Statistical analysis showed overall significant improvement on MCQ assessment after PLAX sectioned model use (Mann‐Whitney U, p<0.05). Performance within MCQ categories showed changes after PLAX model usage in Anatomical Identification (10–25% increase), US View Identification (range of −4‐2% change), and Combined (0–24% increase). No statistical significance (McNemar, p>0.05) was seen on individual questions within each category, except one Anatomical Identification question (McNemar, p<0.05).

The PLAX‐sectioned heart models were perceived as useful resources for learning basic cardiac US, specifically for learner confidence orientating probes in standard US views. Overall, MCQ performance improved after PLAX‐sectioned heart model use. Improvement could not be linked to a specific item category possibly due to small sample size. Plastinated heart models may be a valuable resource for learning cardiac US early in medical training, especially given scanning complexity and time constraints in gross anatomy courses.