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. 2017 Jun;70(3):318-326.
doi: 10.4097/kjae.2017.70.3.318. Epub 2017 Jan 12.

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

T Edward Kim  1   2 , Toni Ganaway  1   2 , T Kyle Harrison  1   2 , Steven K Howard  1   2 , Cynthia Shum  2 , Alex Kuo  1   2 , Edward R Mariano  1   2
Affiliations

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

T Edward Kim et al. Korean J Anesthesiol. 2017 Jun.

Abstract

Background: Anesthesiologists 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.

Methods: Practicing 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.

Results: Survey 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.

Conclusions: Participation in a 1 day simulation-based UGRA course may increase UGRA procedural volume by practicing anesthesiologists.

Keywords: Change implementation; Nerve block; Perineural catheter; Regional anesthesia; Simulation; Ultrasound.

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References

    1. Nix CM, Margarido CB, Awad IT, Avila A, Cheung JJ, Dubrowski A, et al. A scoping review of the evidence for teaching ultrasound-guided regional anesthesia. Reg Anesth Pain Med. 2013;38:471–480. - PubMed
    1. Slater RJ, Castanelli DJ, Barrington MJ. Learning and teaching motor skills in regional anesthesia: a different perspective. Reg Anesth Pain Med. 2014;39:230–239. - PubMed
    1. Kopacz DJ, Neal JM, Pollock JE. The regional anesthesia “learning curve”. What is the minimum number of epidural and spinal blocks to reach consistency? Reg Anesth. 1996;21:182–190. - PubMed
    1. Sites BD, Gallagher JD, Cravero J, Lundberg J, Blike G. The learning curve associated with a simulated ultrasound-guided interventional task by inexperienced anesthesia residents. Reg Anesth Pain Med. 2004;29:544–548. - PubMed
    1. Konrad C, Schüpfer G, Wietlisbach M, Gerber H. Learning manual skills in anesthesiology: Is there a recommended number of cases for anesthetic procedures? Anesth Analg. 1998;86:635–639. - PubMed

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