Learning and Teaching Motor Skills in Regional Anesthesia

Slater, Reuben; Castanelli, Damian; Barrington, Michael J.

doi:10.1097/aap.0000000000000072

Cited by 38 publications

(40 citation statements)

References 29 publications

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“…Performance of ultrasound-guided regional anesthesia (UGRA) can be described as a sequence of steps that requires integration of multiple technical and cognitive skills [12]. A successful UGRA procedure involves knowledge of anatomy, interpretation of sonoanatomy, needle manipulation, and visualization, and confirmation of local anesthetic or catheter tip adjacent to the target nerve(s).…”

Section: Introductionmentioning

confidence: 99%

Implementation of clinical practice changes by experienced anesthesiologists after simulation-based ultrasound-guided regional anesthesia training

Kim

Harrison

Howard

et al. 2017

Korean J Anesthesiol

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BackgroundAnesthesiologists who have finished formal training and want to learn ultrasound-guided regional anesthesia (UGRA) commonly attend 1 day workshops. However, it is unclear whether participation actually changes clinical practice. We assessed change implementation after completion of a 1 day simulation-based UGRA workshop.MethodsPracticing anesthesiologists who participated in a 1 day UGRA course from January 2012 through May 2014 were surveyed. The course consisted of clinical observation of UGRA procedures, didactic lectures, ultrasound scanning, hands-on perineural catheter placement, and mannequin simulation. The primary outcome was the average number of UGRA blocks per month reported at follow-up versus baseline. Secondary outcomes included preference for ultrasound as the nerve localization technique, ratings of UGRA teaching methods, and obstacles to performing UGRA.ResultsSurvey data from 46 course participants (60% response rate) were included for analysis. Participants were (median [10th–90th percentile]) 50 (37–63) years old, had been in practice for 17 (5–30) years, and were surveyed 27 (10–34) months after their UGRA training. Participants reported performing 24 (4–90) blocks per month at follow-up compared to 10 (2–24) blocks at baseline (P < 0.001). Compared to baseline, more participants at follow-up preferred ultrasound for nerve localization. The major obstacle to implementing UGRA in clinical practice was time pressure.ConclusionsParticipation in a 1 day simulation-based UGRA course may increase UGRA procedural volume by practicing anesthesiologists.

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Section: Introductionmentioning

confidence: 99%

Implementation of clinical practice changes by experienced anesthesiologists after simulation-based ultrasound-guided regional anesthesia training

Kim

Harrison

Howard

et al. 2017

Korean J Anesthesiol

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“…Deliberate practice with feedback in a simulated environment can accelerate the rate of skill acquisition , facilitate the transfer to clinical practice, reduce stress and increase self‐confidence in decision‐making. Feedback is a predictor of effective learning and a useful tool for novices learning a new skill . The characteristics of feedback that influence its effect on learning include: timing; content; who (expert/non‐expert) initiates (elicits) it; and the format and motivation applied to its delivery.…”

Section: Introductionmentioning

confidence: 99%

The effect of metrics-based feedback on acquisition of sonographic skills relevant to performance of ultrasound-guided axillary brachial plexus block

et al. 2017

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The objective of this study was to examine the effect of metrics-based vs. non-metrics-based feedback on novices learning predefined competencies for acquisition and interpretation of sonographic images relevant to performance of ultrasound-guided axillary brachial plexus block. Twelve anaesthetic trainees were randomly assigned to either metrics-based-feedback or non-metrics-based feedback groups. After a common learning phase, all participants attempted to perform a predefined task that involved scanning the left axilla of a single volunteer. Following completion of the task, all participants in each group received feedback from a different expert in regional blocks (consultant anaesthetist) and were allowed to practise the predefined task for up to 1 h. Those in the metrics-based feedback group received feedback based on previously validated metrics, and they practised each metric item until it was performed satisfactorily, as assessed by the supervising consultant. Subsequently, each participant attempted to perform ultrasonography of the left axilla on the same volunteer. Two trained consultant anaesthetists independently scored the video recording pre- and post-feedback scans using the validated metrics list. Both groups showed improvement from pre-feedback to post-feedback scores. Compared with participants in the non-metrics-based feedback group, those in the metrics-based feedback group completed more steps: median (IQR [range]) 18.8 (1.5 [17-20]) vs. 14.3 (4.5 [11-18.5]), p = 0.009, and made fewer errors 0.5 (1 [0-1.5]) vs. 1.5 (2 [1-6]), p = 0.041 postfeedback. In this study, novices' sonographic skills showed greater improvement when feedback was combined with validated metrics.

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“…However, a systematic assessment of the evidence has yet been done to determine the effectiveness of simulation-based education for acquisition and maintenance of competence in UGRA. 6,7 We aimed to summarize the existing literature on simulationbased UGRA education to investigate the effectiveness of simulation-based UGRA education. The results will help optimize educational programs in training and maintaining competency for UGRA, ultimately benefiting patient care.…”

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confidence: 99%