title: Shooting with sound: optimizing an affordable ballistic gelatin recipe in a graded ultrasound phantom education program.
abstract: OBJECTIVE
  The goal of this study was to investigate the durability and longevity of gelatin formulas for the production of staged ultrasound phantoms for education.
  
  
  METHODS
  Gelatin phantoms were prepared from Knox gelatin (Kraft Foods, Northfield, IL) and a standard 10%-by-mass ordinance gelatin solution. Phantoms were durability tested by compressing to a 2-cm depth until cracking was visible. Additionally, 16 containers with varying combinations of phenol, container type, and storage location were tested for longevity against desiccation and molding. Once formulation was determined, 4 stages of phantoms from novice to clinically relevant were poured, and clinicians with ultrasound training ranked them on a 7-point Likert scale based on task difficulty, phantom suitability, and fidelity.
  
  
  RESULTS
  On durability testing, the ballistic gelatin outperformed the Knox gelatin by more than 200 compressions. On longevity testing, gelatin with a 0.5% phenol concentration stored with a lid and refrigeration lasted longest, whereas containers without a lid had desiccation within 1 month, and those without phenol became moldy within 6 weeks. Ballistic gelatin was more expensive when buying in small quantities but was 7.4% less expensive when buying in bulk. The staged phantoms were deemed suitable for training, but clinicians did not consistently rank the phantoms in the intended order of 1 to 4 (44%).
  
  
  CONCLUSIONS
  Refrigerated and sealed ballistic gelatin with phenol was a cost-effective method for creating in-house staged ultrasound phantoms suitable for large-scale ultrasound educational training needs. Clinician ranking of phantoms may be influenced by current training methods that favor biological tissue scanning as easier.
authors.affiliation: Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, Virginia USA. taniousf@evms.edu.
authors.forename: Shariff F
authors.initials: SF
authors.lastname: Tanious
authors.affiliation: Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, Virginia USA.
authors.forename: Jamie
authors.initials: J
authors.lastname: Cline
authors.affiliation: Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, Virginia USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Cavin
authors.affiliation: Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, Virginia USA.
authors.forename: Nathan
authors.initials: N
authors.lastname: Davidson
authors.affiliation: Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, Virginia USA.
authors.forename: J Keegan
authors.initials: JK
authors.lastname: Coleman
authors.affiliation: Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, Virginia USA.
authors.forename: Craig W
authors.initials: CW
authors.lastname: Goodmurphy
mesh_terms: D003365:Costs and Cost Analysis; D004501:Education, Medical / Q000191:economics* / Q000379:methods*; D044709:Forensic Ballistics; D005780:Gelatin / Q000191:economics*; D019047:Phantoms, Imaging / Q000191:economics*; D011871:Radiology / Q000193:education*; D000066908:Simulation Training / Q000191:economics*; D014463:Ultrasonography
chemical_list: D005780:Gelatin
keywords: Knox gelatin; ballistic gelatin; medical education; phantom; ultrasound education