Development and Validation of a Three-Dimensional Printed Training Model to Teach Ultrasound-Guided Injections of the Cervical Articular Process Joints in Horses

J Vet Med Educ. 2021 Jun 11;e20200137. doi: 10.3138/jvme-2020-0137. Online ahead of print.

Abstract

Intra-articular injections are routinely performed to alleviate pain and inflammation associated with osteoarthritis in horses. Intra-articular injections require accurate needle placement to optimize clinical outcomes and minimize complications. This study's objectives were to develop and validate a three-dimensional (3D) printed model of an equine cervical articular process joint to teach ultrasound-guided injections. Five identical models of an equine cervical articular process joint were 3D printed and embedded in 10% ballistic gelatin. Experts' and novices' ability to successfully insert a needle into the joint space of the model using ultrasound guidance was assessed and graded using an objective structured clinical examination (OSCE). Scores from experts and novices were compared to evaluate the construct validity of the model. Participants also answered a survey assessing the face and content validity of the model. Experts required less time (22.51 seconds) for correct needle placement into the model joint space than novices (35.96 seconds); however, this difference was not significant (p = .53). Experts' median total OSCE score (14) was significantly higher (p = .03) than novices' (12), supporting the model's construct validity. Participants agreed on the face and content validity of the model by grading all survey questions greater than 7 on a 10-point Likert-type scale. In summary, we successfully developed a 3D printed model of an equine cervical articular process joint, partially demonstrated the construct validity of the model, and proved the face and content validity of this new training tool.

Keywords: equine cervical osteoarthritis; equine medicine; simulation-based medical education; three-dimensional printing; ultrasound-guided joint injections.