Training programmes for healthcare professionals in managing epidural analgesia: A scoping review

Abstract

Background: Epidural analgesia (EA) is widely used for postoperative and labour pain management. Systematic training of healthcare professionals, particularly nurses, is essential for the safe administration and management. This scoping review aimed to identify and map existing EA training programmes.

Methods: A PRISMA-ScR-guided search was conducted across multiple databases and grey literature. Studies on educational interventions for healthcare professionals in EA management were included. Data extraction and categorisation were performed using Kirkpatrick's Four-Level Training Evaluation Model.

Results: Eighteen studies were included, covering classroom training, workshops, self-directed learning, simulation-based training, and on-the-job training. Participants were primarily nurses. Programmes addressed epidural techniques, monitoring and assessment, spinal anatomy and pharmacology, complication management, and patient care. Most studies focused on short-term knowledge gains, with a limited assessment of long-term clinical impacts.

Conclusion: Limited research exists on EA training, with most programmes targeting nurses and relying on classroom-based training. Training structures varied, and evaluations primarily assessed short-term knowledge gains.

Editorial comment: The authors conducted a literature search to get an overview of programmes that aimed to train healthcare staff in managing epidural pain relief. Most of the identified 18 studies described classroom teaching and focused primarily on knowledge about complications. Patient contact in this type of training was not reported. The effectiveness of this type of training in a clinical context was difficult to evaluate based on the published evidence.

Keywords: clinical education; educational interventions; epidural analgesia; healthcare professionals; pain management; training programmes.

FIGURE 1

PRISMA flow chart of study selection: training programmes in epidural analgesia management.

FIGURE 2

Didactic approaches used within the different training modalities. The rectangle sizes reflect the frequency of each component's use in the included studies.

FIGURE 3

Key topics in training programmes—font size reflects the frequency of topics addressed in the training programmes.

FIGURE 4

Overview of assessment levels and tools, categorising the tools used in the studies by their focus on professional development outcomes (PDO) and clinical outcomes (CO).