Korean J Anesthesiol.  2017 Jun;70(3):318-326. 10.4097/kjae.2017.70.3.318.

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

• Kim TE
• Ganaway T
• Harrison T
• Howard SK
• Shum C
• Kuo A
• Mariano ER

• KMID: 2382749
• DOI: http://doi.org/10.4097/kjae.2017.70.3.318

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.

Keyword

Change implementation; Nerve block; Perineural catheter; Regional anesthesia; Simulation; Ultrasound

MeSH Terms

Anesthesia, Conduction*
Catheters
Education
Follow-Up Studies
Lectures
Manikins
Nerve Block
Teaching
Ultrasonography