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

Abstract

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.

Impact of an ultrasound-guided regional anesthesia workshop on participants&apos; confidence levels and clinical practice

“…Few participants stated adequate equipment as a factor increasing their use of UGRA. The study by Kim et al [4] also demonstrated that available equipment was not a barrier for most practicing anesthesiologists. These findings are in contrast to the 2010 survey, which found that the most difficult challenge to overcome for members was the availability of ultrasound equipment [5].…”

“…Additionally, most participants stated that the workshop made a relevant impact on their clinical practice. Kim et al [4] also assessed an UGRA workshop for practicing anesthesiologists, reporting that participants performed more UGRA blocks after the workshop. The subjective findings from our survey offer support that workshop attendance facilitates changes in clinical practice.…”

Simulation-based ultrasound-guided regional anesthesia curriculum for anesthesiology residents

“…For practice of UGRA technical skills, numerous simulated models have been introduced, including self-assembled phantoms (gelatin, meat, tofu) [34,36,37], commercially available trainers [25,38], hybrid simulators [39,40], and cadavers [6,41,42]. Simulation-based training in needle visualization has been shown to improve hand-eye coordination [43], decrease technical errors [44], and reduce number of needle passes [45].…”

Virtual reality simulator’s effectiveness on the spine procedure education for trainee: a randomized controlled trial

“…Therefore, cadaver training for procedures has dwindled under the currently implemented social distancing measures in the face of the coronavirus disease 2019 (COVID-19) pandemic [4]. One perspective is that the pandemic has acted as a catalyst to facilitate a paradigm shift in traditional education methods; it is expected that traditional methods will eventually be replaced by alternatives such as online education, 3D printing, multimedia resources, and virtual/augmented reality [5,6].…”