Using psychometric ability to improve education in ultrasound‐guided regional anaesthesia: a multicentre randomised controlled trial

Abstract

The learning curve for novices developing regional anaesthesia skills, such as real-time ultrasound-guided needle manipulation, may be affected by innate visuospatial ability, as this influences spatial cognition and motor coordination. We conducted a multinational randomised controlled trial to test if novices with low visuospatial ability would perform better at an ultrasound-guided needling task with deliberate practice training than with discovery learning. Visuospatial ability was evaluated using the mental rotations test-A. We recruited 140 medical students and randomly allocated them into low-ability control (discovery learning), low-ability intervention (received deliberate practice), high-ability control, and high-ability intervention groups. Primary outcome was the time taken to complete the needling task, and there was no significant difference between groups: median (IQR [range]) low-ability control 125 s (69-237 [43-600 s]); low-ability intervention 163 s (116-276 [44-600 s]); highability control 130 s (80-210 [41-384 s]); and high-ability intervention 177 s (113-285 [43-547 s]), p = 0.06. No difference was found using the global rating scale: mean (95%CI) low-ability control 53% (95%CI 46-60%); lowability intervention 61% (95%CI 53-68%); high-ability control 63% (95%CI 56-70%); and high-ability intervention 66% (95%CI 60-72%), p = 0.05. For overall procedure pass/fail, the low-ability control group pass rate of 42% (14/ 33) was significantly less than the other three groups: low-ability intervention 69% (25/36); high-ability control 68% (25/37); and high-ability intervention 85% (29/34) p = 0.003. Further research is required to determine the role of visuospatial ability screening in training for ultrasound-guided needle skills.

Unravelling the skillset of point-of-care ultrasound: a systematic review

“…The underlying framework of visuospatial ability can be used in various ways to improve US education. Chuan et al [ 52 ] showed that if medical students with low visuospatial ability receive extra training in mental rotation, they can achieve the same UGRA performance scores as their fellow students with higher visuospatial abilities. Furthermore, Hewson et al [ 55 ] specifically trained students’ mental rotation with a simple task and improved UGRA performance.…”

Design and validation of a virtual reality trainer for ultrasound‐guided regional anaesthesia

“…A pork meat phantom with embedded bovine tendon was constructed as per our previous work [6,7]. This phantom closely resembles human nerve and muscle structures under ultrasound and allowed us to capture ultrasound images of needles inserted at multiple angles.…”

“…Novice participants were shown a 10-min training video previously used in our work [6,7] that explained the fundamentals of ultrasound physics, transducer movements and in-plane needle guidance under ultrasound. All participants were orientated to the virtual reality equipment and then allowed to explore the virtual reality trainer environment to familiarise themselves with the motion controllers and ultrasound scan the virtual patient.…”