title: Teaching percutaneous renal biopsy using unfixed human cadavers.
abstract: BACKGROUND
  Percutaneous renal biopsy (PRB) is an important diagnostic procedure. Despite advances in its safety profile there remains a small but significant risk of bleeding complications. Traditionally, operators train to perform PRB through tutor instruction and directly supervised PRB attempts on real patients. We describe an approach to teaching operators to perform PRB using cadaveric simulation.
  
  
  METHODS
  We devised a full day course hosted in the Clinical Anatomy Skills Centre, with places for nine candidates. Course faculty consisted of two Consultant Nephrologists, two Nephrology trainees experienced in PRB, and one Radiologist. Classroom instruction included discussion of PRB indications, risk minimisation, and management of complications. Two faculty members acted as models for the demonstration of kidney localisation using real-time ultrasound scanning. PRB was demonstrated using a cadaveric model, and candidates then practised PRB using each cadaver model.
  
  
  RESULTS
  Written candidate feedback was universally positive. Faculty considered the cadaveric model a realistic representation of live patients, while the use of multiple cadavers introduced anatomical variation.
  
  
  CONCLUSIONS
  Our model facilitates safe simulation of a high risk procedure. This might reduce serious harm associated with PRB and improve patient safety, benefiting trainee operators and patients alike.
authors.affiliation: School of Medicine, University of Glasgow, Scotland, UK. s.oliver.1@research.gla.ac.uk.|Renal and Transplant Unit, Queen Elizabeth University Hospital, Glasgow, Scotland, UK. s.oliver.1@research.gla.ac.uk.|Medical Education, NHS Lanarkshire, Bothwell, Scotland, UK. s.oliver.1@research.gla.ac.uk.|Postgraduate Office, Wishaw General Hospital, 50 Netherton Street, Wishaw, ML2 0DP, UK. s.oliver.1@research.gla.ac.uk.
authors.forename: Scott W
authors.initials: SW
authors.lastname: Oliver
authors.affiliation: Renal and Transplant Unit, Queen Elizabeth University Hospital, Glasgow, Scotland, UK. rajan.patel@glasgow.ac.uk.
authors.forename: Rajan K
authors.initials: RK
authors.lastname: Patel
authors.affiliation: Radiology Department, Queen Elizabeth University Hospital, Glasgow, Scotland, UK. kali1@nhs.net.
authors.forename: Khalid A
authors.initials: KA
authors.lastname: Ali
authors.affiliation: Renal and Transplant Unit, Queen Elizabeth University Hospital, Glasgow, Scotland, UK. Colin.Geddes@ggc.scot.nhs.uk.|Clinical Skills Anatomy Centre, University of Glasgow, Scotland, UK. Colin.Geddes@ggc.scot.nhs.uk.
authors.forename: Colin C
authors.initials: CC
authors.lastname: Geddes
authors.affiliation: Renal and Transplant Unit, Queen Elizabeth University Hospital, Glasgow, Scotland, UK. Bruce.MacKinnon2@ggc.scot.nhs.uk.|Clinical Skills Anatomy Centre, University of Glasgow, Scotland, UK. Bruce.MacKinnon2@ggc.scot.nhs.uk.
authors.forename: Bruce
authors.initials: B
authors.lastname: MacKinnon
mesh_terms: D001706:Biopsy / Q000379:methods*; D002102:Cadaver; D006282:Health Personnel / Q000193:education; D006801:Humans; D007668:Kidney / Q000473:pathology*; D009398:Nephrology / Q000193:education*