Development of a Model for Training and Assessing Open Image-Guided Liver Tumor Ablation

Kaled Diab, Suhas Kochat, James McClintic, Heather Stevenson-Lerner, Steven Agle, Kelly Olino, Douglas Tyler, Kimberly M. Brown

Research output: Contribution to journalArticlepeer-review


Background: Image-guided microwave ablation (MWA) is a technically demanding procedure, involving advanced visual-spatial perception skills. This study sought to create and evaluate a low-cost model and training curriculum for open ultrasound-guided liver tumor MWA. Methods: Simulated tumors were created, implanted into bovine livers, and visualized by ultrasound. A high-fidelity abdominal model was constructed, with a total cost of $30. Experienced physicians in MWA performed simulated ablations and evaluated the model. Expert performance metrics were established and served as targets for our training curriculum. These included time, number of passes, number of repositionings, and percentage of tumor ablated. Next, 8 novice trainees completed our deliberate practice curriculum. Participants’ performances were recorded throughout. Results: Physicians completed a structured feedback questionnaire rating the model's realism and training utility at 8/10 and 10/10, respectively. Tumors appeared hyperechoic and were clearly visualized on ultrasound. Trainees performed a total of 32 ablations. Our trainees’ performance improved significantly in all outcomes of interest in the postcurriculum ablations compared to precurriculum ablations. Conclusion: We have created a cost-effective, high-fidelity model of MWA, with a deliberate practice curriculum. Trainees can practice to proficiency with clear target metrics prior to participating in clinical cas

Original languageEnglish (US)
JournalJournal of Surgical Education
StateAccepted/In press - Jan 1 2018


  • ablation
  • liver
  • microwave
  • simulation training
  • ultrasound

ASJC Scopus subject areas

  • Surgery
  • Education

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