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Chuan A, Jeyaratnam B, Iohom G, Shorten G, Lee P, Miglani S, Kwofie K, Szerb J, Niazi AU, Jin R, Jen T, McCartney CJ, Ramlogan R. Using psychometric ability to improve education in ultrasound-guided regional anaesthesia: a multicentre randomised controlled trial. Anaesthesia 2021; 76:911-917. [PMID: 33458816 DOI: 10.1111/anae.15353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2020] [Indexed: 11/29/2022]
Abstract
The learning curve for novices developing regional anaesthesia skills, such as real-time ultrasound-guided needle manipulation, may be affected by innate visuospatial ability, as this influences spatial cognition and motor co-ordination. We conducted a multinational randomised controlled trial to test if novices with low visuospatial ability would perform better at an ultrasound-guided needling task with deliberate practice training than with discovery learning. Visuospatial ability was evaluated using the mental rotations test-A. We recruited 140 medical students and randomly allocated them into low-ability control (discovery learning), low-ability intervention (received deliberate practice), high-ability control, and high-ability intervention groups. Primary outcome was the time taken to complete the needling task, and there was no significant difference between groups: median (IQR [range]) low-ability control 125 s (69-237 [43-600 s]); low-ability intervention 163 s (116-276 [44-600 s]); high-ability control 130 s (80-210 [41-384 s]); and high-ability intervention 177 s (113-285 [43-547 s]), p = 0.06. No difference was found using the global rating scale: mean (95%CI) low-ability control 53% (95%CI 46-60%); low-ability intervention 61% (95%CI 53-68%); high-ability control 63% (95%CI 56-70%); and high-ability intervention 66% (95%CI 60-72%), p = 0.05. For overall procedure pass/fail, the low-ability control group pass rate of 42% (14/33) was significantly less than the other three groups: low-ability intervention 69% (25/36); high-ability control 68% (25/37); and high-ability intervention 85% (29/34) p = 0.003. Further research is required to determine the role of visuospatial ability screening in training for ultrasound-guided needle skills.
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Affiliation(s)
- A Chuan
- Department of Anaesthesia, Liverpool Hospital, Sydney, NSW, Australia.,South West Sydney Clinical School and Ingham Institute of Applied Medical Research, UNSW Sydney, Sydney, NSW, Australia
| | - B Jeyaratnam
- Department of Anaesthesia, Liverpool Hospital, Sydney, NSW, Australia.,South West Sydney Clinical School and Ingham Institute of Applied Medical Research, UNSW Sydney, Sydney, NSW, Australia
| | - G Iohom
- Department of Anaesthesia and Intensive Care, Cork University Hospital, Cork, Ireland
| | - G Shorten
- Department of Anaesthesia and Intensive Care, Cork University Hospital, Cork, Ireland
| | - P Lee
- Department of Anaesthesia and Intensive Care, Cork University Hospital, Cork, Ireland
| | - S Miglani
- Department of Anaesthesia and Intensive Care, Cork University Hospital, Cork, Ireland
| | - K Kwofie
- Department of Anesthesia, Pain Management and Peri-operative Medicine, Dalhousie University, Halifax, NS, Canada
| | - J Szerb
- Department of Anesthesiology, Toronto Western Hospital-University Health Network, ON, Canada
| | - A U Niazi
- Department of Anesthesiology, Toronto Western Hospital-University Health Network, ON, Canada
| | - R Jin
- Department of Anesthesiology and Pain Medicine, Ottawa Hospital, ON, Canada
| | - T Jen
- Department of Anesthesiology and Pain Medicine, Ottawa Hospital, ON, Canada
| | - C J McCartney
- Department of Anesthesiology and Pain Medicine, Ottawa Hospital, ON, Canada.,Department of Anesthesiology and Pain Medicine, Ottawa Hospital, ON, Canada
| | - R Ramlogan
- Department of Anesthesiology and Pain Medicine, Ottawa Hospital, ON, Canada
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Burckett-St.Laurent DA, Cunningham MS, Abbas S, Chan VW, Okrainec A, Niazi AU. Teaching ultrasound-guided regional anesthesia remotely: a feasibility study. Acta Anaesthesiol Scand 2016; 60:995-1002. [PMID: 26860837 DOI: 10.1111/aas.12695] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 01/03/2016] [Accepted: 01/12/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Ultrasound-guided regional anesthesia (UGRA) requires acquisition of new skills. Learning requires one-on-one teaching, and can be limited by time and mentor availability. We investigate whether the skills required for UGRA can be developed and subsequently assessed remotely using a novel online teaching platform. This platform was developed at the University of Toronto to teach laparoscopic surgery remotely and has been termed Telesimulation. METHODS Anesthesia Site Chiefs at 10 hospitals across Ontario were sent a letter inviting their anesthesia teams to participate in an UGRA remote training program. Four to five anesthetists from each site were recruited from the first four hospitals expressing interest. Simulation models and ultrasound machines were set up at each location and connected via Skype(™) and web cameras with the Telesimulation center at our hospital. Training consisted of four online sessions and one offline lecture in order to teach an ultrasound-guided supraclavicular block. Participants were evaluated before and after training by on-site and off-site assessors using a validated Checklist and Global Rating Scale (GRS). RESULTS Nineteen staff anesthetists were recruited. Post-training scores were significantly higher across both assessment tools, on-site (P < 0.001) and off-site training locations (P = 0.003). The inter-rater reliability between on-site and remote training site ratings was good for the Checklist (ICC = 0.672, 95% CI: 0.369-0.830) and excellent for the GRS (ICC = 0.847, 95% CI: 0.706-0.921). CONCLUSION This study demonstrates that UGRA can be taught remotely. Future research will focus on comparing this method to on-site teaching and its application in resource-restricted countries.
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Affiliation(s)
- D. A. Burckett-St.Laurent
- Department of Anesthesia and Pain Management; Toronto Western Hospital-University Health Network; Toronto ON Canada
- Temerty/Chang International Centre for Telesimulation and Innovative Medical Education; Toronto Western Hospital-University Health Network; Toronto ON Canada
| | - M. S. Cunningham
- Temerty/Chang International Centre for Telesimulation and Innovative Medical Education; Toronto Western Hospital-University Health Network; Toronto ON Canada
| | - S. Abbas
- Department of Anesthesia and Pain Management; Toronto Western Hospital-University Health Network; Toronto ON Canada
| | - V. W. Chan
- Department of Anesthesia and Pain Management; Toronto Western Hospital-University Health Network; Toronto ON Canada
| | - A. Okrainec
- Temerty/Chang International Centre for Telesimulation and Innovative Medical Education; Toronto Western Hospital-University Health Network; Toronto ON Canada
- Division of General Surgery; Toronto Western Hospital-University Health Network; Toronto ON Canada
| | - A. U. Niazi
- Department of Anesthesia and Pain Management; Toronto Western Hospital-University Health Network; Toronto ON Canada
- Temerty/Chang International Centre for Telesimulation and Innovative Medical Education; Toronto Western Hospital-University Health Network; Toronto ON Canada
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