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

Abstract

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.

YouTube as an informational source for brachial plexus blocks: evaluation of content and educational value

“… 20 It has been shown that these sonographic skills were performed more successfully by anesthesia trainees when they were provided with expert-guided feedback. 21 Although we do not recommend YouTube videos as a learning tool as per our findings, publishing recordings of these modern regional anesthesia training videos together with explanatory feedback points may help watchers to understand the steps and errors made by trainees. These videos when made by reputable medical institutes might be quite beneficial for regional anesthesia trainees or residents.…”

Efficacy of a certified modular ultrasound curriculum

“…It has been shown that education taught on non-ideal, real-world patients and not healthy volunteers can increase the efficacy of learning [17]. In addition, novices' sonographic skills showed greater improvement when feedback was combined with validated met- rics [1]. Systematic reviews have shown that simulation-based training in health care is significantly more effective than alternative teaching methods or no intervention [7].…”

Metric-Based Simulation Training to Proficiency for Endovascular Thrombectomy in Ischemic Stroke

“…The PBP approach to training is based on solid research and has been validated in different healthcare settings for over a decade [e.g., laparoscopic (11)(12)(13), arthroscopic (20,21), robotic (22), endovascular skills (23), anesthetic (24)(25)(26), mechanical thrombectomy for ischemic stroke (5), and communication skills (27)]. Results from the first multicenter randomized prospective trial of proficiency-based progression simulation training (for an arthroscopic shoulder procedure) showed that intra-operative errors were reduced by 56% when compared to the standard approach to training (21).…”