The online version of this article (doi:10.1186/1471-2253-14-110) contains supplementary material, which is available to authorized users.
Gabriella Iohom, Brian D O’Donnell and George D Shorten contributed equally to this work.
The authors declare that they have no competing interests.
OOS, GI, BDOD and GDS contributed to the conception and design of the study. OOS and GDS collected and analyzed the data. OOS and GDS drafted the manuscript. GI and BDOD made critical revisions of the manuscript. All authors read and approved the final manuscript.
In preparing novice anesthesiologists to perform their first ultrasound-guided axillary brachial plexus blockade, we hypothesized that virtual reality simulation-based training offers an additional learning benefit over standard training. We carried out pilot testing of this hypothesis using a prospective, single blind, randomized controlled trial.
We planned to recruit 20 anesthesiologists who had no experience of performing ultrasound-guided regional anesthesia. Initial standardized training, reflecting current best available practice was provided to all participating trainees. Trainees were randomized into one of two groups; (i) to undertake additional simulation-based training or (ii) no further training. On completion of their assigned training, trainees attempted their first ultrasound-guided axillary brachial plexus blockade. Two experts, blinded to the trainees’ group allocation, assessed the performance of trainees using validated tools.
This study was discontinued following a planned interim analysis, having recruited 10 trainees. This occurred because it became clear that the functionality of the available simulator was insufficient to meet our training requirements. There were no statistically significant difference in clinical performance, as assessed using the sum of a Global Rating Score and a checklist score, between simulation-based training [mean 32.9 (standard deviation 11.1)] and control trainees [31.5 (4.2)] (p = 0.885).
We have described a methodology for assessing the effectiveness of a simulator, during its development, by means of a randomized controlled trial. We believe that the learning acquired will be useful if performing future trials on learning efficacy associated with simulation based training in procedural skills.
ClinicalTrials.gov identifier: NCT01965314. Registered October 17th 2013.
Additional file 1: Task Specific Checklist and Global Rating Scale for assessment Ultrasound Guided Axillary Brachial Plexus Block performance.(DOCX 24 KB)
Frank JR, Snell LS, Cate OT, Holmboe ES, Carraccio C, Swing SR, Harris P, Glasgow NJ, Campbell C, Dath D, Harden RM, Iobst W, Long DM, Mungroo R, Richardson DL, Sherbino J, Silver I, Taber S, Talbot M, Harris KA: Competency-based medical education: theory to practice. Med Teach. 2010, 32: 638-645. 10.3109/0142159X.2010.501190. CrossRefPubMed
Cook DA, Hatala R, Brydges R, Zendejas B, Szostek JH, Wang AT, Erwin PJ, Hamstra SJ: Technology-enhanced simulation for health professions education: a systematic review and meta-analysis. JAMA. 2011, 306: 978-988. PubMed
Sultan SF, Shorten G, Iohom G: Simulators for training in ultrasound guided procedures. Med Ultrason. 2013, 15: 125-131. 10.11152/mu.2013.2066.152.sfs1gs2. CrossRef
Barrington MJ, Wong DM, Slater B, Ivanusic JJ, Ovens M: Ultrasound- guided regional anesthesia: how much practice do novices require before achieving competency in ultrasound needle visualization using a cadaver model. Reg Anesth Pain Med. 2012, 37: 334-339. 10.1097/AAP.0b013e3182475fba. CrossRefPubMed
Ekstrom RB, French JW, Harman HH, Dermen D: Manual for kit of factor- referenced cognitive tests. 1976, Princeton, NJ: Educational testing service
Sites BD, Chan VW, Neal JM, Weller R, Grau T, Koscielniak-Nielsen ZJ, Ivani G, American Society of Regional Anesthesia and Pain Medicine, European Society Of Regional Anaesthesia and Pain Therapy Joint Committee: The American society of regional anesthesia and pain medicine and the European society of regional anaesthesia and pain therapy joint committee recommendations for education and training in ultrasound-guided regional anesthesia. Reg Anesth Pain Med. 2009, 34: 40-46. 10.1097/AAP.0b013e3181926779. CrossRefPubMed
- The effect of simulation-based training on initial performance of ultrasound-guided axillary brachial plexus blockade in a clinical setting – a pilot study
Brian D O’Donnell
George D Shorten
- BioMed Central
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