Palpation guided fine needle aspiration
Training in superficial FNA procedure

Topic Completed: 1 August 2013

Revised: 3 January 2019, last major update August 2013

Copyright: (c) 2002-2018,, Inc.

PubMed Search: Training in superficial FNA procedure

Joseph D. Jakowski, M.D.
Page views in 2019: 94
Page views in 2020 to date: 17
Cite this page: Jakowski J. D. Training in superficial FNA procedure. website. Accessed May 26th, 2020.
Definition / general
  • There is little agreement on what adequate FNA training might consist of as the effectiveness of specific and defined training methods for FNA are currently lacking
  • For pathologists, initial training in superficial FNA may be accomplished through:
    • Pathology residency programs that include training in FNA
    • Cytopathology fellowship
  • The procurement of the FNA samples is not as easy as generally perceived as demonstrated by the fact that:
    • Contrary to popular belief, the mere performance of a large number of FNAs does not improve results when controlled for level of training
    • Significant improvement in FNA results occur when:
      • The FNA procedure is concentrated in fewer hands
      • The same physician performs both the FNA procedure AND microscopically examines the specimen
      • Proper training is obtained
Important factors
  • The most important factors in mastering the FNA procedures are:
    • Focused training with an expert practitioner in FNA
    • Appropriate and consistent feedback to the aspirator on the specimen:
      • Quality
      • Collection
      • Preparation
Achieving proficiency
  • The number of FNA procedures needed for achieving proficiency will vary depending on:
    • Individual background (e.g. previous experience in medical or invasive procedures or other biopsy experience)
    • Skill set (e.g. hand eye and fine motor coordination)
    • FNA case mix during training
Overall strategies and goals
  • Train for technical excellence in sample preparation
  • Start with easier, large palpable targets
  • Other challenging cases need to be included in training
  • Goal of obtaining at least 90% diagnostic specimens before training is complete
  • Unsatisfactory sample rate of < 10% is a probable measure of proficiency
Additional components
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