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Standardised training program in spinal ultrasound for epidural insertion: protocol driven versus non-protocol driven teaching approach.

Abstract：

:Spinal ultrasonography provides guidance for epidural insertion in obstetric patients. The primary objective of the study was to develop a training program in spinal ultrasound for anaesthetists and to determine its effect on the skill acquisition of anaesthetists with no prior spinal ultrasound experience. Eighteen anaesthetists underwent two structured workshops (one week apart), each followed by a practice session and videorecorded assessments. Participants were randomised to a protocol-driven or non-protocol driven spinal ultrasound teaching program. Two experts rated each individual's performance using a global rating scale (GRS), checklist and image quality scale. The primary outcome was the mean difference in GRS score between the two workshops, analysed using linear mixed models. Intraclass correlation coefficients were calculated to assess agreement between assessors' ratings. A total of 108 ultrasound scans were performed on five pregnant volunteers during the assessment periods. After adjusting for confounders, GRS scores increased on all three rating scales at the second workshop, this increase being 6.01 points (95% confidence interval 4.56 to 7.46, P<0.001) from a mean score of 28.4 (95% confidence interval 24.8 to 32.0). There was no significant difference in the scores between the two teaching groups (difference in GRS scores=1.36 points, 95% confidence interval -0.77 to 3.50, P=0.211). Intraclass correlation coefficients showed substantial assessor agreement for all three assessment methods (range 0.59 to 0.89). The results demonstrate that programmed spinal ultrasound training sessions involving practice with guidance and feedback from an expert, whether protocol-based or non-protocol based, lead to improved performance.

journal_name

Anaesth Intensive Care

journal_title

Anaesthesia and intensive care

authors

Terblanche NC,Arzola C,Wills KE,Lawson R,Blackford D,Balki M

doi

10.1177/0310057X1404200406

subject

Has Abstract

pub_date

2014-07-01 00:00:00

pages

460-6

issue

eissn

0310-057X

issn

1448-0271

pii

20130619

journal_volume

pub_type

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Standardised training program in spinal ultrasound for epidural insertion: protocol driven versus non-protocol driven teaching approach.