Martin Gavin, Lineberger Catherine K, MacLeod David B, El-Moalem Habib E, Breslin Dara S, Hardman David, D'Ercole Francine
Department of Anesthesia, Duke University Health System, Duke North Hospital Room 3438, Box 3094, Durham, NC 27710, USA.
Anesth Analg. 2002 Nov;95(5):1423-7, table of contents. doi: 10.1097/00000539-200211000-00059.
The adequacy of resident education in regional anesthesia is of national concern. A teaching model to improve resident training in regional anesthesia was instituted in the Anesthesiology Residency in 1996 at Duke University Health System. The key feature of the model was the use of a CA-3 resident in the preoperative area to perform regional anesthesia techniques. We assessed the success of the new model by comparing the data supplied by the Anesthesiology Residency to the Residency Review Committee for Anesthesiology for the training period July 1992-June 1995 (pre-model) and the training period July 1998-June 2001 (post-model). During the 3-yr training period, the pre-model CA-3 residents (n = 12) performed a cumulative total of 80 (58-105) peripheral nerve blocks (PNBs), 66 (59-74) spinal anesthetics, and 133 (127-142) epidural anesthetics. The CA-3 post-model residents (n = 10) performed 350 (237-408) PNBs, 107 (92-123) spinal anesthetics, and 233 (221-241) epidural anesthetics (P < 0.0001). All results are reported as median (interquartile range). We conclude that our new teaching model using our CA-3 residents as block residents in the preoperative area has increased their clinical exposure to PNBs.
Inadequate exposure to peripheral nerve blocks has been a national problem. A teaching model instituted at Duke University Health System has resulted in a fourfold increase in exposure to peripheral nerve blocks compared with the national averages.
区域麻醉住院医师教育的充分性是全国关注的问题。1996年,杜克大学健康系统麻醉学住院医师培训项目设立了一种教学模式,以改善区域麻醉住院医师培训。该模式的关键特征是在术前区域安排一名CA - 3住院医师来实施区域麻醉技术。我们通过比较麻醉学住院医师培训项目提供给麻醉学住院医师评审委员会的数据,评估了新模式在1992年7月至1995年6月培训期(模式前)和1998年7月至2001年6月培训期(模式后)的成效。在3年的培训期内,模式前的CA - 3住院医师(n = 12)累计共实施了80例(58 - 105例)外周神经阻滞(PNB)、66例(59 - 74例)脊髓麻醉和133例(127 - 142例)硬膜外麻醉。模式后的CA - 3住院医师(n = 10)实施了350例(237 - 408例)PNB、107例(92 - 123例)脊髓麻醉和233例(221 - 241例)硬膜外麻醉(P < 0.0001)。所有结果均报告为中位数(四分位间距)。我们得出结论,我们在术前区域将CA - 3住院医师作为阻滞麻醉住院医师的新教学模式增加了他们对外周神经阻滞的临床接触。
外周神经阻滞接触不足一直是个全国性问题。杜克大学健康系统设立的一种教学模式使外周神经阻滞的接触量比全国平均水平增加了四倍。