Objective: There has been a rapid growth in the use of ultrasound-guided regional anesthesia in the past decade. Residency programs have been trying to find the best way to teach these newer techniques. Our department decided to develop a teaching workshop for our residents with the purpose of improving knowledge and skills in ultrasound-guided regional anesthesia. The hypothesis was that the workshop would improve overall knowledge of ultrasound-guided regional anesthesia as determined by a test developed for this activity. In addition, the goal was to help improve imaging and technical skills.
Methods: A one-day workshop was organized for the CA1 and CA3 resident classes. The workshop was organized with the following learning objectives: (1) be able to identify basic ultrasound anatomy; (2) learn how to apply principles of ultrasound physics in order to obtain good ultrasound images; (3) develop basic ultrasound imaging skills on human models; and (4) develop needle visualization skills on gel models. The workshop included: a pre-test, a 2-hour didactic session, a 2-hour imaging and skills workshop, and a post-test. A twenty-question exam was developed by our faculty for this activity.
Results: A total of 20 residents participated in the two workshops. Tests scores (number correct out of twenty) were 9.5 ± 2.8 for the pre-test and 16.0 ± 1.9 for the post-test (P < 0.0001). This is an improvement in test scores of 68% from the pretest. CA1 pre-test scores were 10.1 ± 2.7, with post-test scores of 15.9 ± 1.7 (P < 0.0005). CA3 pre-test scores were 9.1 ± 3.9, with post-test scores of 16.1 ± 2.0 (P < 0.0001). There was no statistical difference between the classes (P = 0.129). Test scores obtained from the CA1 class (n = 7) one-year after the workshop were 16.7 ± 0.95. There was no significant difference between the post test scores and one-year scores (P = 0.262).
Conclusions: Both CA1 and CA3 resident post-test scores improved at the end of the ultrasound guided regional workshop. Our study showed a 68% improvement in test scores, which is larger than the 50% improvement previously reported. These results show that fast learning can occur in this type of setting. Furthermore, knowledge acquired during the workshop was retained when CA1 residents were re-tested one year after the workshop. The ultrasound-guided regional anesthesia workshop will become part of the didactic series for our CA1 residents and will be a required learning activity. Additional work still needs to be done to find out the best way to test knowledge and skill outcomes in residents learning new technology and techniques.
Keywords: anesthesia; peripheral nerve blocks; residency education; ultrasound guidance.