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

Chuan, Alwin; Jeyaratnam, Bahaven; Iohom, Gabrielle; Shorten, George; Lee, P.; Miglani, Sanjay; Kwofie, Kwesi; Szerb, Jennifer; Niazi, Ahtsham U.; Jin, Rongyu; Jen, Tim T. H.; McCartney, Colin J. L.; Ramlogan, Reva

doi:10.1111/anae.15353

Cited by 4 publications

(4 citation statements)

References 25 publications

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2023

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Background The increasing number of physicians that are trained in point-of-care ultrasound (POCUS) warrants critical evaluation and improvement of current training methods. Performing POCUS is a complex task and it is unknown which (neuro)cognitive mechanisms are most important in competence development of this skill. This systematic review was conducted to identify determinants of POCUS competence development that can be used to optimize POCUS training. Methods PubMed, Web of Science, Cochrane Library, Emcare, PsycINFO and ERIC databases were searched for studies measuring ultrasound (US) skills and aptitude. The papers were divided into three categories: “Relevant knowledge”, “Psychomotor ability” and ‘Visuospatial ability’. The ‘Relevant knowledge’ category was further subdivided in ‘image interpretation’, ‘technical aspects’ and ‘general cognitive abilities’. Visuospatial ability was subdivided in visuospatial subcategories based on the Cattell-Horn-Carroll (CHC) Model of Intelligence v2.2, which includes visuospatial manipulation and visuospatial perception. Post-hoc, a meta-analysis was performed to calculate pooled correlations. Results 26 papers were selected for inclusion in the review. 15 reported on relevant knowledge with a pooled coefficient of determination of 0.26. Four papers reported on psychomotor abilities, one reported a significant relationship with POCUS competence. 13 papers reported on visuospatial abilities, the pooled coefficient of determination was 0.16. Conclusion There was a lot of heterogeneity in methods to assess possible determinants of POCUS competence and POCUS competence acquisition. This makes it difficult to draw strong conclusions on which determinants should be part of a framework to improve POCUS education. However, we identified two determinants of POCUS competence development: relevant knowledge and visuospatial ability. The content of relevant knowledge could not be retrieved in more depth. For visuospatial ability we used the CHC model as theoretical framework to analyze this skill. We could not point out psychomotor ability as a determinant of POCUS competence.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2023

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“…Traditional modified radical mastectomy involves the induction of general anesthesia to relieve pain [18,19]. Although general anesthesia plays a certain inhibitory role in the limbic system of the cerebral cortex, it cannot block the conduction of peripheral noxious stimuli to the central nervous system, thereby promoting stress responses in patients during surgery [7,20,21].…”

Section: Discussionmentioning

confidence: 99%

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

2023

European Journal of Gynaecological Oncology

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This research aims to investigate the effect of ultrasound-guided continuous thoracic paravertebral nerve block in patients undergoing radical mastectomy. Ninety-six patients who underwent radical mastectomy were equally divided into a study group (administered with a continuous thoracic paravertebral nerve block and general anesthesia) and a control group (given conventional general anesthesia) with a random number table. At T2–T4 (T2: immediate tracheal intubation; T3: at skin incision; T4: at extubation), mean artery pressure (MAP) and hear rate (HR) were significantly lower in the study group (p < 0.05); however, there was no significant difference in blood oxygen saturation (SpO2) between the two groups at different time points. At T2–T4, cortisol (Cor) levels were significantly lower in the study group (p < 0.05). At T0–T2, there was no significant difference in the levels of adrenocorticotropic hormone (ACTH) between the two groups. At T3–T4, the levels of ACTH in the study group were significantly lower (p < 0.05). There were no significant differences in blood pressure between the two groups at any time point. At the moment of discharge from the resuscitation room and 2 hours after surgery, the numerical rating scale (NRS) score in the study group was significantly reduced (p < 0.05). The incidence of adverse reactions in the study group was 10.42%; this was lower than that in the control group (33.33%) (p < 0.05). Finally, the use of fentanyl and propofol, and the frequency of analgesic pump use, were significantly lower in the study group (p < 0.05). Ultrasound-guided thoracic paravertebral nerve block can effectively maintain hemodynamic stability, improve the stress response, reduce postoperative pain, reduce the use of anesthetic drugs, and effectively control the incidence of adverse reactions in patients undergoing radical mastectomy.

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“…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.…”

Section: Methodsmentioning

confidence: 99%

“…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.…”

Section: Methodsmentioning

confidence: 99%

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

et al. 2023

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Virtual reality is a form of high-fidelity simulation that may be used to enhance the quality of medical education. We created a bespoke virtual reality trainer software using high resolution motion capture and ultrasound imagery to teach cognitive-motor needling skills necessary for the performance of ultrasound-guided regional anaesthesia. The primary objective of this study was to determine the construct validity between novice and experienced regional anaesthetists. Secondary objectives were: to create learning curves for needling performance; compare the virtual environment immersion with other high-fidelity virtual reality software; and compare cognitive task loads imposed by the virtual trainer compared with real-life medical procedures. We recruited 21 novice and 15 experienced participants, each of whom performed 40 needling attempts on four different virtual nerve targets. Performance scores for each attempt were calculated based on measured metrics (needle angulation, withdrawals, time taken) and compared between the groups. The degree of virtual reality immersion was measured using the Presence Questionnaire, and cognitive burden was measured using the NASA-Task Load Index. Scores by experienced participants were significantly higher than novices (p = 0.002) and for each nerve target (84% vs. 77%, p = 0.002; 86% vs. 79%, p = 0.003; 87% vs. 81%, p = 0.002; 87% vs. 80%, p = 0.003). Log-log transformed learning curves demonstrated individual variability in performance over time. The virtual reality trainer was rated as being comparably immersive to other high-fidelity virtual reality software in the realism, possibility to act and quality of interface subscales (all p > 0.06) but not in the possibility to examine and self-performance subscales (all p < 0.009). The virtual reality trainer created workloads similar to those reported in real-life procedural medicine (p = 0.53). This study achieved initial validation of our new virtual reality trainer and allows progression to a planned definitive trial that will compare the effectiveness of virtual reality training on real-life regional anaesthesia performance.

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

Cited by 4 publications

References 25 publications

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

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

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

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

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