Implementation of clinical practice changes by experienced anesthesiologists after simulation-based ultrasound-guided regional anesthesia training.
10.4097/kjae.2017.70.3.318
- Author:
T Edward KIM
1
;
Toni GANAWAY
;
T Kyle HARRISON
;
Steven K HOWARD
;
Cynthia SHUM
;
Alex KUO
;
Edward R MARIANO
Author Information
1. Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, USA. emariano@stanford.edu
- Publication Type:Original Article
- Keywords:
Change implementation;
Nerve block;
Perineural catheter;
Regional anesthesia;
Simulation;
Ultrasound
- MeSH:
Anesthesia, Conduction*;
Catheters;
Education;
Follow-Up Studies;
Lectures;
Manikins;
Nerve Block;
Teaching;
Ultrasonography
- From:Korean Journal of Anesthesiology
2017;70(3):318-326
- CountryRepublic of Korea
- Language:English
-
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.