Article Text
PDF
Abstract
Please confirm that an ethics committee approval has been applied for or granted: Not relevant
Background and Aims Performance of nerve block using ultrasound has improved success, reduced errors, and minimized complications. Skills related to the use of ultrasound are difficult to learn, however simulation has been proposed [Gallagher et al] as it allows trainees to rehearse procedural skills safely. To be effective, simulation must be integrated into a validated curriculum.
Methods We undertook a series of studies in Cork University Hospital, Ireland to develop, validate and implement training programme relevant to performance of ultrasound guided axillary brachial plexus block (UGABPB). A panel of experts deconstructed the task of performing UGABPB to identify metrics and errors [Ahmed et al]. Thereafter, face and content validity were verified using a modified Delphi method. Metrics and errors were subjected to a validation process [Ahmed et al]. Video recording experts and novices performing the block on live patients were captured and assessed by two independent observers using validated metrics. The inter-rater reliability between the two observers was measured. Trainees were randomly allocated to either metric-based training group or traditional training group.
Results 54 metrics and 32 errors were identified and unambiguously defined. Compared to novices, experts scored more steps and committed less errors when assessed using validated metrics. Construct validity was verified with an inter-rater reliability of more than 0.8. Trainees randomly allocated to metric based curriculum outperform their traditionally trained counterparts when they were assessed performing UGABPB in simulated platforms.
Ultrasound guided brachial plexus block
Training using phantom gel
Conclusions Metric based simulation training improved novice performance of UGABPB in simulation platform. Future studies should examine the impact on patients’ clinical outcomes.