Ultrasound-guided training on Fascia Iliaca Compartment Block and Pericapsular Nerve Group Block for 5 -year medical students using soft cadavers.

BACKGROUND

Ultrasound-guided Fascia Iliaca Compartment Block (FICB) and Pericapsular Nerve Group (PENG) Block are effective, non-addictive pain management methods for older adults with hip fractures. To address the opioid adverse events such as delirium, alternative pain management techniques are essential. This study aimed to evaluate the effectiveness of a hands-on ultrasound-guided workshop in improving medical students' competence in performing FICB and PENG blocks.

METHODS

A one-group pretest-posttest design involving 72 participants was employed. Fifth-year medical students enrolled in a geriatric medicine rotation participated in a half-day workshop comprising theoretical instruction and hands-on ultrasound practice using soft cadavers. Competency (ultrasound images, indications and contraindications, and performance on cadaver) was assessed by an emergency physician trained in ultrasound-guided nerve block.

RESULTS

A total of 72 participants were enrolled to our study. The ability to identify anatomy via ultrasound image improved significantly (mean score before training: 0.9/5 points ± 0.8, mean score after training: 4.0/5 points ± 1.2, mean difference (95%CI): 3.1 (2.9 to 3.4), p < 0.001). Confidence in identifying landmarks and performing FICB and PENG blocks also improved significantly (mean score before training: 0.6/5 points Likert Scale ± 0.8, mean score after training: 3.5/5 points Likert Scale ± 0.9, p < 0.001). The total performance score after training significantly improved, with a mean score 20.3/24 points.

CONCLUSIONS

Medical students can acquire the skills to perform ultrasound-guided PENG and FICB blocks for hip fractures in older adults through targeted teaching sessions. These findings support the inclusion of PENG and FICB blocks in medical curricula or any geriatric rotation focused on pain management.