Anaesthesia Trainees’ Exposure to Regional Anaesthesia in an Australian Tertiary Adult Teaching Hospital

Abstract

The purpose of this study was to quantify the exposure of anaesthetic trainees to regional anaesthesia in an Australian tertiary adult teaching hospital. We reviewed data collected on all regional blocks performed by the anaesthetic department over a two-year period. The data was then broken down to give an estimate of the number of each block performed by each training year group. There was an average of 27.7 full-time equivalent trainees attached to the department. Trainees performed a total of 1374 blocks over this period. The average number of blocks performed by basic training year one trainees each year was 6.5, basic training year two trainees 13.5, advanced training year one trainees 14.9, advanced training year two trainees 19.1, advanced training year three trainees 23.1 and regional fellows 144.0. The number of total blocks and the proportion of advanced blocks increased with increasing level of training while supervision declined. Trainees in the two regional fellowship positions (7% of the trainee pool) performed 42% of the 1374 blocks. Factors that may influence the exposure of trainees to regional anaesthesia and the assessment of competency are considered.

Audit of anesthetic trainees’ ‘hands‐on’ operating room experience in an Australian tertiary children's hospital

“…Several Australian studies looking at adult anesthesia experience, namely regional anesthesia and airway management , have been published and have identified aspects of trainee experience that are lacking such as particular airway techniques (intubations, awake fiber‐optic intubations). We therefore set out to establish the experience gained in pediatric anesthesia by registrars in our institution, in order to assess compliance with the new ANZCA curriculum, to assess training deficits and provide a benchmark for other pediatric anesthetic training institutions.…”

“…In line with Clarke's retrospective study , we do not have previous data but we believe there has been a reduction in the number of intubations by our trainees. The reasons for this perceived reduction are similar but not identical to those suggested by Clarke , i.e., the increasing use of the laryngeal mask airway and a reduction in training hours, but not an increasing use of regional anesthesia alone, because of the nature of our purely pediatric practice.…”

“…We generally perform about 100 fiber‐optic intubations and place about 50 epidurals per year at our institution, so it is likely that registrars observe more than they perform themselves. Our institution does not offer advanced regional or airway Fellowship training programs, so unlike some adult tertiary departments that do , experience of these techniques is spread evenly among our trainees.…”

“…We are certain that we collected data from every session that a registrar worked. We also were able to differentiate between cases and procedures that a registrar performed vs those performed by a consultant; this differentiation has not been achieved in other similar audits on registrar experience in a retrospective setting .…”