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CSEM

CSEM2404 - CSEM Resident Oral Abstract Presentations - Development of a Thyroid Biopsy Assessment Tool for Learner Evaluation

Thursday, November 21, 2024
14:14 - 14:21 AT Time
Location: Argyle A3

    Presenting Author(s)

  • Melissa Ge, MD, FRCPC

    Endocrinology Resident
    Western University
    London, Ontario, Canada

    Disclosure(s): I do not have a relationship with a for-profit and/or a not-for-profit organization to disclose

    • Submitting Author(s)

  • Melissa Ge, MD, FRCPC

    Endocrinology Resident
    Western University
    London, Ontario, Canada

    Disclosure(s): I do not have a relationship with a for-profit and/or a not-for-profit organization to disclose

    • First Author(s)

  • Melissa Ge, MD, FRCPC

    Endocrinology Resident
    Western University
    London, Ontario, Canada

    Disclosure(s): I do not have a relationship with a for-profit and/or a not-for-profit organization to disclose

    • Co-Author(s)

  • CHRISTOPHER TRAN, MD, FRCPC, MMEd (he/him/his)

    Endocrinologist
    The Ottawa Hospital
    University of Ottawa
    Ottawa, Ontario, Canada

    Disclosure information not submitted.

Abstract:

Introduction: Ultrasound-guided fine needle aspiration biopsy (FNA-B) is an essential diagnostic modality for thyroid nodules. While most Canadian Endocrinology residency programs offer FNA-B training, no formal resources exist to inform resident feedback on FNA-B technique. We aimed to use consensus group methods to develop an assessment tool for thyroid FNA-B.

Methods: As informed by literature review and discussion with experts, we created an initial 19-item procedure list for thyroid FNA-B. We used a modified Delphi method to establish consensus on items for inclusion within the assessment tool using 5-point Likert scales. We sent surveys to Canadian endocrinologists with expertise in thyroid FNA-B, with multiple rounds for re-rating of items not meeting consensus, and a wrap-up meeting to finalize items.


Results: After one round, seven respondents reached consensus on 15 items. Highest ranked steps included obtaining patient consent (5.0), localizing anatomical landmarks like large blood vessels (4.9), tracking the needle tip on ultrasound (4.9), and hematoma counselling/monitoring (4.9). No items met consensus to be removed. Items not meeting consensus included anticoagulation management (4.3), discussion of when to abort the procedure (3.9), and discussion of aspiration vs. non-aspiration techniques (3.9).

Discussion: Early findings highlight the essential steps for ultrasound guided FNA-B of thyroid nodules as informed by an expert panel, while revealing variations in practice across Canada. Once finalized, a formal assessment tool can help inform feedback on resident thyroid FNA-B technique following observed encounters – a timely resource given the impending transition of Endocrinology to Competence By Design.