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. 2025 Dec;80(12):1493-1500.
doi: 10.1111/anae.16724. Epub 2025 Jul 31.

Development of an assessment tool for ultrasound-guided regional anaesthesia image interpretation

Sam J Haddad  1 , Mayur Murali  2 , Shun W S Ko  3 , Madan Narayanan  4 , James S Bowness  5   6 , Peter Merjavy  7   8 , Lloyd Turbitt  9 , Alan J R Macfarlane  10   11 , Amit Pawa  3   12 , Boyne Bellew  13   14 ; URAISE Collaborator Group
Collaborators, Affiliations

Development of an assessment tool for ultrasound-guided regional anaesthesia image interpretation

Sam J Haddad et al. Anaesthesia. 2025 Dec.

Abstract

Introduction: The success of ultrasound-guided regional anaesthesia depends on the acquisition and interpretation of optimal ultrasound images. This study aimed to develop an assessment tool to evaluate proficiency in interpreting ultrasound images for regional anaesthesia.

Methods: This study involved domain and item generation; preliminary testing; and content validity evaluation by an expert panel review. Questions were generated by the study group and pilot testing was conducted with UK-based anaesthesia consultants and resident doctors. Face validity was tested by thematic analysis of participant feedback questionnaires, discriminative ability using Rasch modelling of item response and internal reliability using Cronbach's α method.

Results: A 57-item pilot test was completed by 43 participants across clinical experiences from stage 1 training to consultant. Median (IQR [range]) completion time was 55 (41-64 [29-94]) min and fatigue point was question 49 of 57 (37-57 [15-57]). Rasch analysis led to the exclusion of seven items and content validity evaluation resulted in the removal of a further six items, resulting in a 44-item question set. The test showed good face validity, with a Cronbach's α of 0.92, indicating high internal reliability.

Discussion: This study produced a 44-item assessment tool to assess the proficiency of ultrasound image interpretation in regional anaesthesia for a range of upper limb, lower limb and truncal blocks, with proven face validity, internal reliability and content validity. Further testing with a larger sample is planned to verify reliability and validity, with the hope that this may be an asset for regional anaesthesia training and assessment.

Keywords: assessment; interpretation; sono‐anatomy; tool.

Plain language summary

When doctors use ultrasound to help with pain relief during surgery (called regional anaesthesia), they need to clearly see and understand the pictures from the ultrasound machine. This study tried to make a test to check how well doctors can do that. The study team came up with questions for the test. They first tested it with anaesthesia doctors and students in the UK. They also asked experts to check if the test made sense. They used feedback from the people who took the test to see if it was clear and fair. They also used methods to check if the test worked well and was reliable. A test with 57 questions was given to 43 people, from beginner doctors to experts. On average, it took about 55 minutes to finish. People started getting tired around question 49. After checking the results and feedback, they removed 13 questions that didn't work well. The final test had 44 questions. The test was found to be clear and dependable, with high scores for reliability. This study created a 44‐question test to check how well doctors understand ultrasound pictures used in certain types of pain relief (like for the arms, legs and chest). The test seems to work well, but more testing with a bigger group of people will help make sure it's a useful tool for training and testing doctors.

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Figures

Figure 1
Figure 1
Test sample question with ultrasound clip and answer.
See this image and copyright information in PMC

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