Ultrasound-guided regional anesthesia: feasibility and effectiveness of teaching via telesimulation in Ethiopia

Reg Anesth Pain Med. 2021 Aug;46(8):722-726. doi: 10.1136/rapm-2020-102394. Epub 2021 Apr 26.


Background: Acute pain management in resource-poor countries remains a challenge. Ultrasound-guided regional anesthesia is a cost-effective way of delivering analgesia in these settings. However, for financial and logistical reasons, educational workshops are inaccessible to many physicians in these environments. Telesimulation provides a way of teaching across distance by using simulators and video-conferencing software to connect instructors and students worldwide. We conducted a prospective study to determine the feasibility of ultrasound-guided regional anesthesia teaching via telesimulation in Ethiopia.

Methods: Eighteen Ethiopian orthopedic and emergency medicine house staff participated in telesimulation teaching of ultrasound-guided femoral nerve block. This consisted of four 90-min sessions, once per week. Week 1 consisted of a precourse test and a presentation on aspects of performing a femoral nerve block, weeks 2 and 3 were live teaching sessions on scanning and needling techniques, and in week 4, the house staff undertook a postcourse test. All participants were assessed using a validated Global Rating Scale and Checklist.

Results: Participants were provided with a validated checklist and global rating scale as a pretest and post-test. The participants showed significant improvement in their test scores, from a total mean of 51% in the pretest to 84% in their post-test.

Conclusions: Teaching ultrasound-guided regional anesthesia of the femoral nerve remotely via telesimulation is feasible. Telesimulation can greatly improve the accessibility of ultrasound-guided regional anesthesia teaching to physicians in remote areas.

Keywords: education; lower extremity; regional anesthesia; ultrasonography.

MeSH terms

  • Anesthesia, Conduction*
  • Ethiopia
  • Feasibility Studies
  • Humans
  • Prospective Studies
  • Ultrasonography, Interventional