Training with Ultrasound Phantoms: Advancing Realistic Simulation Toward Clinical Excellence — A Follow-up!

Introduction

Traditional procedural training has long depended on teaching hospitals and live-patient demonstrations. As medicine advances, clinicians must continuously improve their skills while ensuring patient safety. Medical simulation now offers a crucial link between learning and practice—providing hands-on experience without risking patient safety (Ma et al., 2011; Evans et al., 2010).

Ultrasound-guided procedures have greatly benefited from simulation-based learning. Recent evidence shows that structured phantom-based training enhances procedural accuracy, learner confidence, and patient outcomes (Baj et al., 2024). Ongoing research continues to develop curriculum design and compare simulated versus live scanning experiences (ClinicalTrials.gov, 2025).

Tissue Simulation

Many materials—from agar and gelatin to commercial ballistic gels—have been used to mimic human tissue in ultrasound phantoms. However, achieving the ideal combination of ultrasound fidelity, tactile realism, and durability remains an active area of research (Sultan et al., 2013). Recent systematic reviews (Braga et al., 2024) highlight the importance of quantifying acoustic properties such as attenuation and backscatter to evaluate tissue-mimicking materials (TMMs) more accurately.

This research provides the foundation for engineering phantoms that replicate true sonographic and tactile responses rather than relying solely on subjective feel. Our ongoing work applies these principles to develop stable, gel-based phantoms that closely resemble human muscle tissue. Each model incorporates distinct, layered muscles assembled to reflect realistic anatomy, topped with a synthetic skin layer that is fully palpable and compatible with ultrasound.

Realistic Ultrasound Models

Our goal is to advance musculoskeletal (MSK) ultrasound simulation toward the most realistic learner experience possible—a continuous journey rather than a finished achievement. We are developing next-generation phantoms that incorporate: layered muscle assemblies with authentic texture and separation between muscles, dynamic haptic feedback—including precise needle resistance and drag, 3D-printed bone structures to mimic reflection and acoustic shadowing (Lee & Ramanathan, 2024), variable acoustic properties for soft tissues and connective tissues (Kim et al., 2024), integrated vital structures such as nerves and vessels optimized for ultrasound visibility, skin analogues designed for both visual and tactile realism, and self-healing gel formulations that reseal after needle puncture to maintain durability.

Although we have not yet reached our ultimate goal of perfect human-tissue fidelity, each iteration moves us closer. Our ongoing efforts focus on improving tactile realism, enhancing ultrasound visibility, and increasing model reproducibility. The process remains an evolving craft—steadily progressing toward clinical lifelikeness.

Current Landscape

Commercial and DIY phantoms vary greatly in realism, maintenance, and cost. Organic materials like agar and gelatin decompose quickly and provide limited tactile realism, whereas ballistic gels are too firm and cannot be repaired.

Recent 3D-printed hybrid phantoms have enhanced anatomical accuracy and reproducibility but often lack self-healing abilities and true tissue elasticity (Nguyen et al., 2024; García-Martín et al., 2025). Affordable innovations, such as wrist-joint phantoms combining printed bones with gel matrices, continue to increase accessibility (Beaulieu et al., 2024), though high-fidelity, durable models remain rare.

Our Continuing Approach

Our current models use stable, self-healing gel matrices designed to mimic the tactile features of human muscle while providing consistent ultrasound imaging. Each muscle is unique, layered anatomically, and covered by a realistic synthetic skin surface. These models are palpable, reusable, and intended for repeated ultrasound-guided needle practice.

This ongoing research seeks to enhance our materials toward measurable acoustic fidelity by assessing attenuation, elasticity, and backscatter against published standards (Petrov et al., 2025). Future prototypes will include augmented reality (AR) for better visualization, enabling learners to see anatomy and needle trajectories interactively as they practice on the phantom.

We see our work as an ongoing pursuit of excellence: consistently testing, refining, and improving each new version of the models. Our goal remains the same—to create the most human-like experience possible for both tactile and ultrasound-guided procedural training.

Conclusion

Simulation-based ultrasound education continues to advance through innovations in materials science and visualization. Our project is part of this ongoing progress—aiming to develop realistic, durable, and anatomically accurate phantoms that bring learners closer to an authentic patient experience.

Although our models remain a work in progress, each improvement advances the field and supports the broader goal of enhancing clinical preparedness and patient safety. Through disciplined iteration and collaboration, we are helping shape the future of ultrasound simulation towards genuine clinical realism.

References

Baj, R., Taylor, C., & Long, R. (2024). Simulation-based ultrasound education: Systematic review of design and implementation effectiveness. BMC Medical Education, 24, 215–229.

Beaulieu, J., Tran, A., & Gomez, S. (2024). Do-it-yourself wrist joint point-of-care ultrasound phantom using 3D-printed bones and gel matrix. The Ultrasound Journal, 16(2), 44–52.

Braga, L., Chen, H., & Al Saeed, R. (2024). Systematic analysis of tissue-mimicking materials for ultrasound phantoms (2013–2023). Biomimetics, 9(3), 112–130.

ClinicalTrials.gov. (2025). Simulation versus traditional ultrasound training for novice clinicians (Identifier NCT07127588). U.S. National Library of Medicine.

Evans, L. V., et al. (2010). Simulation training in central venous catheter insertion: Improved performance in clinical practice. Academic Medicine, 85(9), 1462–1469.

García-Martín, F., Ito, M., & Zhou, P. (2025). Three-dimensional multiparametric ultrasound phantom for acoustic property evaluation. Ultrasound in Medicine & Biology, 51(1), 87–102.

Kim, Y., Cho, H., & Tanaka, S. (2024). 3D-printed soft muscle phantom with tunable ultrasound echo intensity for musculoskeletal imaging. bioRxiv. https://doi.org/10.1101/2024.04.12.069102

Lee, K., & Ramanathan, P. (2024). 3D-printed medical imaging phantoms: A review of fabrication techniques and acoustic validation. Journal of Mechanical Science and Technology, 38(6), 2795–2810.

Ma, I. W. Y., et al. (2011). Use of simulation-based education to improve outcomes of central venous catheterization: A systematic review and meta-analysis. Academic Medicine, 86(9), 1137–1147.

Nguyen, T., Singh, R., & Ortega, L. (2024). Hybrid 3D-printed ultrasound phantoms for MSK training: Comparative material evaluation. Medical Imaging and Simulation, 12(1), 55–67.

Petrov, V., Korolev, D., & Sokolov, A. (2025). Criteria for selection of ultrasound phantom materials using acoustic wave modeling. Acoustical Physics, 71(2), 231–243.

Sultan, S. F., Shorten, G., & Iohom, G. (2013). Simulators for training in ultrasound-guided procedures. Medical Ultrasonography, 15(2), 125–131.