Physician Assistant Student Simulation Training in Ultrasound-Guided Procedures Using Synthetic Cysts and Formalin-Embalmed Cadavers

Betsy Piburn; Alden Harring; Kristi Collins; Isain Zapata; Andrew Thomson; Nena Lundgreen Mason

doi:10.1097/JPA.0000000000000681

Physician Assistant Student Simulation Training in Ultrasound-Guided Procedures Using Synthetic Cysts and Formalin-Embalmed Cadavers

J Physician Assist Educ. 2025 Jun 25. doi: 10.1097/JPA.0000000000000681. Online ahead of print.

Authors

Betsy Piburn^{1

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6}, Alden Harring^{1

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6}, Kristi Collins^{1

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6}, Isain Zapata^{1

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6}, Andrew Thomson^{1

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6}, Nena Lundgreen Mason^{1

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6}

Affiliations

¹ Betsy Piburn, DMS, PA-C, is an assistant professor, Physician Assistant Studies, Masters of Physician Assistant Studies Program, Franklin Pierce University, Lebanon, New Hampshire.
² Alden Harring, is a second year medical student, Department of Medical Education at Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
³ Kristi Collins, DScPAS, PA-C, is an adjunct professor, Physician Assistant Studies; Director, Medical Education Services, Masters of Physician Assistant Studies Program, Franklin Pierce University, Lebanon, New Hampshire; Department of Medical Education, MaineHealth, Portland, Maine.
⁴ Isain Zapata, PhD, is an associate professor of Biomedical Sciences, Assistant Director, Office of Research, Rocky Vista University College of Osteopathic Medicine, Parker, Colorado.
⁵ Andrew Thomson, MD, is an assistant professor of Emergency Medicine, Department of Emergency Medicine, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire.
⁶ Nena Lundgreen Mason, PhD, is an associate professor of Medical Education, Ultrasound Educator, Department of Medical Education, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.

PMID: 40556070
DOI: 10.1097/JPA.0000000000000681

Abstract

Introduction: Traditionally, if ultrasound needle-guidance training is included in physician assistant (PA) education it occurs during the clinical year and uses live patients at the bedside. This practice requires learning a highly tactile skill in a high-stress learning environment where mistakes during the learning process will likely result directly in patient discomfort or complication-related injury. Simulation training with formalin-embalmed cadavers can provide realistic training opportunities with no risk to patients. This study examines the effectiveness of integrating simulation training in ultrasound-guided percutaneous cyst drainage into PA education.

Methods: Thirty-seven PA student participants engaged in training activities to learn to use ultrasound to access and drain synthetic cysts embedded within cadaver tissue. Participants were assessed using pre-training and post-training self-confidence questionnaires and objective skills examinations administered by an instructor.

Results: Participant self-confidence related to all assessed aspects of performing the procedure significantly increased after training (P < 0.0001). Only 2 participants were unable to successfully pass the skills assessment. Participants required 1.9 needle sticks on average to complete the procedure successfully in an average time of 143 seconds.

Discussion: Simulation training using synthetic cysts and formalin-embalmed cadavers provides PA students with a realistic and low-stress learning environment in which to develop the complex tactile skills needed to successfully guide a needle with ultrasound while performing a clinical procedure. Training sessions like this should be integrated into PA education to allow students to safely develop the skills and confidence they need to perform ultrasound-guided procedures on live patients and minimize risk of adverse outcomes.