Regional anaesthesia assessment tools – a reply

Chuan, Alwin; Forrest, Kirsty; Barrington, Michael J.; Royse, Colin; Wong, Daniel M.; Cameron, A. F.; Lim, Yean Chin; Auyong, David B.

doi:10.1111/anae.13430

Cited by 2 publications

(2 citation statements)

References 12 publications

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“…As ICC is a form of analysis of variance (ANOVA), the test can correct for chance variance, and is able to measure consistency and absolute agreement between scores. 18 This is particularly important when compared with Pearson correlation, which can only measure consistency. In practical terms, Pearson correlation sets the upper limit of ICC values in ideal situations, but the calculated ICC is much lower.…”

Section: Validitymentioning

confidence: 99%

Competency-based assessment tools for regional anaesthesia: a narrative review

Chuan

Wan

Royse

et al. 2018

British Journal of Anaesthesia

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Competency-based assessment tools are used in regional anaesthesia to measure the performance of study participants, trainees, and consultants. This narrative review was performed to appraise currently published assessment tools for regional anaesthesia. A literature search found 397 citations of which 28 peer-reviewed studies met the inclusion criteria of primary psychometric evaluation of assessment tools for regional anaesthesia. The included studies were diverse in the type of assessment and the skill set being assessed. The types of assessments included multiple-choice questions, hand-motion analysis, cumulative sum, visuospatial and psychomotor screening, checklists, and global rating scales. The skill sets that were assessed included holistic regional anaesthesia technical and non-technical performance observed at the bedside, to isolated part-tasks, such as needle tip visualisation under ultrasound. To evaluate validity and reliability, we compared the studies against published medical education consensus statements on ideal assessment tools. We discuss the relative merits of different tools when used to assess regional anaesthesia, the importance of psychometrically robust assessment tools in competency-based anaesthesia education, and directions for future education research in regional anaesthesia.

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Section: Validitymentioning

confidence: 99%

Competency-based assessment tools for regional anaesthesia: a narrative review

Chuan

Wan

Royse

et al. 2018

British Journal of Anaesthesia

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“…Indeed, a gold standard tool would require trainees to perform procedures on actual patients. 24,25 Variability in the steepness of ultrasound learning curves 26,27 makes predicting trainee proficiency prior to performing a procedure difficult. In our study, consultants were less likely to assume the role of primary proceduralist if the trainee was an advanced trainee, suggesting consultants allow experienced trainees more independence.…”

Section: Discussionmentioning

confidence: 99%

A retrospective observational study of patient analgesia outcomes when regional anaesthesia procedures are performed by consultants versus supervised trainees

Chin

Foster

Pelecanos

et al. 2022

Anaesth Intensive Care

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At teaching hospitals, consultants must provide effective supervision, including appropriate selection of teaching cases, such that the outcomes achieved by trainees are similar to that of consultants. Numerous studies in the surgical literature have compared patient outcomes when surgery is performed by consultant surgeons or surgical trainees but, to our knowledge, none exist in the field of anaesthesia. We aimed to compare analgesia outcomes of regional anaesthesia when performed by supervised trainees versus consultants. We designed a retrospective observational study using registry data. The primary outcome was inadequate analgesia, defined as a numerical rating scale (NRS) for pain >5 reported at any time in the post-anaesthesia care unit (PACU). Secondary outcomes included the maximum pain NRS, pain experienced in the PACU, and the requirement for systemic opioid analgesia in the PACU. Of the 1814 patients analysed, the primary proceduralist was a consultant for 514 (28.3%) patients and a trainee for 1300 (71.7%) patients. All trainees were supervised by an on-site consultant. There were no statistically significant differences between consultants and supervised trainees in terms of the primary outcome (NRS >5 in 24.9% and 24.5% of patients, respectively; P = 0.84) and secondary outcomes. Compared to trainees, consultants had a slightly higher rate of patients with a body mass index >30 kg/m2, an American Society of Anesthesiologists Physical Status Classification of 3 or 4, nerve blocks performed under general anaesthesia, paravertebral/neuraxial blocks and blocks with perineural catheter placement. Regional anaesthesia performed by supervised trainees can achieve similar analgesia outcomes to consultant-performed procedures.

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Regional anaesthesia assessment tools – a reply

Cited by 2 publications

References 12 publications

Competency-based assessment tools for regional anaesthesia: a narrative review

Competency-based assessment tools for regional anaesthesia: a narrative review

A retrospective observational study of patient analgesia outcomes when regional anaesthesia procedures are performed by consultants versus supervised trainees

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