Simulation in teaching regional anesthesia: current perspectives

Abstract

The emerging subspecialty of regional anesthesiology and acute pain medicine represents an opportunity to evaluate critically the current methods of teaching regional anesthesia techniques and the practice of acute pain medicine. To date, there have been a wide variety of simulation applications in this field, and efficacy has largely been assumed. However, a thorough review of the literature reveals that effective teaching strategies, including simulation, in regional anesthesiology and acute pain medicine are not established completely yet. Future research should be directed toward comparative-effectiveness of simulation versus other accepted teaching methods, exploring the combination of procedural training with realistic clinical scenarios, and the application of simulation-based teaching curricula to a wider range of learner, from the student to the practicing physician.

Keywords: medical education; nerve block; regional anesthesia; simulation; simulator; ultrasound.

Figure 1

Sample sonogram of a nonanatomic inorganic phantom for ultrasound-guided regional anesthesia. Note: Inset box indicates external view of the model.

Figure 2

Sample sonogram of an anatomic inorganic phantom for ultrasound-guided regional anesthesia. Note: Inset box indicates external view of the model.

Figure 3

Sample sonogram of an organic phantom for ultrasound-guided regional anesthesia using a porcine meat specimen with inserted bovine tendon to represent the target “nerve” (arrowheads identify the tendon). Note: Inset box indicates external view of the model.

Figure 4

Example of a “hybrid” simulator with the right lower extremity of the mannequin removed and replaced with a porcine-bovine meat phantom to allow for realistic procedural practice in ultrasound-guided regional anesthesia and perineural catheter insertion.