• Ziwei Lin, Crystal Harn Wei Soh, Mui Teng Chua, Jingping Lin, Cheryl Jing Yi Ho, Julia Ying Hui Lee, Fang Yu Tracy Shen, Ying Wei Yau, and Win Sen Kuan.
• Emergency Medicine Department, National University Hospital, National University Health System, Singapore.
• Ann Acad Med Singap. 2020 Dec 1; 49 (12): 971-977.

IntroductionPericardiocentesis is a potentially life-saving procedure. We compared two low-cost models-an agar-based model and a novel model, Centesys-in terms of ultrasound image quality and realism, effectiveness of the model, and learners' confidence and satisfaction after training.MethodsIn this pilot randomised 2x2 crossover trial stratified by physician seniority, participants were assigned to undergo pericardiocentesis training either with the agar-based or Centesys model first, followed by the other model. Participants were asked to rate their confidence in performing ultrasound-guided pericardiocentesis, clarity and realism of cardiac structures on ultrasound imaging, and satisfaction on a 7-point Likert scale before and after training with each model.ResultsTwenty participants with median postgraduate year of 4 (interquartile range [IQR] 3.75-6) years were recruited. Pre-training, participants rated themselves a median score of 2.5 (IQR 2-4) for level of confidence in performing pericardiocentesis, which improved to 5 (IQR 4-6) post-training with Centesys (P=0.007). Centesys was recognised to be more realistic in simulating cardiac anatomy on ultrasound (median 5 [IQR 4-5] versus 3.5 [IQR 3-4], P=0.002) than the agar-based model. There was greater satisfaction with Centesys (median 5 [IQR 5-6] versus 4 [IQR 3.75-4], P<0.001). All 20 participants achieved successful insertion of a pericardial drain into the simulated pericardial sac with Centesys.ConclusionCentesys achieved greater learner satisfaction as compared to the agar-based model, and was an effective tool for teaching ultrasound-guided pericardiocentesis and drain insertion.

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