Education and training in ultrasound-guided regional anaesthesia and pain medicine

Abstract

Purpose of review Effective and safe regional anaesthesia and pain medicine procedures require clinicians to learn and master complex theoretical knowledge and motor skills. This review aims to summarize articles relevant to education and training in these skill sets in the previous 2 years. Recent findings Twenty-two articles were identified, investigating nine out of the 13 top-ranked research topics in education and training in regional anaesthesia. Research topics addressed by these articles included prerotation simulation, deliberate practice combined with formative assessment tools, validation of assessment tools, three-dimensional-printed models, and knowledge translation from simulation to clinical practice. Emerging concepts investigated for their applications in regional anaesthesia included eye-tracking as a surrogate metric when evaluating proficiency, and elastography aiding visual salience to distinguish appropriate perineural and inappropriate intraneural injections. Summary Research into education and training in regional anaesthesia covered multiple and diverse topics. Methodological limitations were noted in several articles, reflecting the difficulties in designing and conducting medical education studies. Nonetheless, the evidence-base continues to mature and innovations provide exciting future possibilities.

Validation of the soft-embalmed Thiel cadaver as a high-fidelity simulator of pressure during targeted nerve injection

“…There is a pressing need to train anesthesiologists in regional anesthesia skills. Both low fidelity 2 and high fidelity simulators 3 show benefit 4 , but must be accurate enough for participants to engage in a lifelike way 5 in order to correctly position the tip of the needle relative to the target nerve and experience the realistic ranges of injection pressures. The benefit of high-fidelity replication of pressure, as well other features such as elasticity, resilience and durability, is that it enables deliberate practice 6 -the repetition and successive refinement of performance, a cornerstone of the expert-performance approach to skills training 7 .…”

Ultrasound-guided thoracic paravertebral nerve block in patients undergoing radical mastectomy

“…Furthermore, compared with the traditional surface location and nerve stimulator guidance method, the ultrasoundguided visualization technique is highly effective, convenient and associated with fewer complications. Ultrasound-guided nerve blocks can allow anesthesiologists to focus directly on the direction of the puncture needle, needle insertion, needle tip position, and the spread of local anesthetics, thus reducing the complications caused by puncture while improving the success rate of the procedure [10][11][12][13].…”

The Development of a Virtual Simulator for a Novel Design Non-Permanent Magnetic Needle Based Eye Anesthesia Training System

“…Therefore, in practical cases, ophthalmologists must go through extensive practices before operating. In general, the type of practice for eye anesthesia is a cadaveric training system [8]- [10]. After the fresh cadaver is acquired, the expert physicians supervise the trainees in the practice procedures, focusing on their postures and the remaining needle length [9], [10].…”