Lim M W, Burt G, Rutter S V
Nuffield Department of Anaesthetics, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, UK.
Br J Anaesth. 2005 Mar;94(3):372-7. doi: 10.1093/bja/aei060. Epub 2004 Dec 24.
Using commercial computer graphics software (TrueSpace), we constructed a virtual-reality model for teaching interscalene brachial plexus block. This tool combines the clarity of schematic drawings and the clinical relevance of video clips and live demonstrations. The aim is to accelerate learning and aid retention of relevant information.
We made a series of continuous short virtual-reality animations demonstrating the steps to perform an interscalene block. Superficial structures were made transparent to show the anatomical relevance of landmarking and needle manipulation. The clips were presented to delegates at a training course in Oxford. Delegates were surveyed to ascertain whether or not the presentation enhanced their understanding of anatomy and regional block technique. Before and after the presentation, delegates indicated surface landmarking, needle angulation, and movement on photographs of the lateral and anterolateral neck views of two volunteers. The markings were analysed by two independent assessors and rated as 'good', 'bad', or 'ungradeable'. The percentage improvement for each skill group was calculated and McNemar's test applied.
Of 24 respondents, the majority thought that the presentation enhanced their understanding of the anatomical (87.5%) and technical principles (79.2%) of interscalene blocks. Analysis of the marked photographs showed an overall 24.1% improvement in landmarking skills after the teaching presentation (P<0.001). Changes were significant in moderately experienced skill groups (P<0.001) but not for the very experienced (P>0.5) and the inexperienced skill groups (P<0.1). There was 76.3% concordance in scoring between the two assessors.
Three-dimensional animation is a promising new tool to accelerate the learning of regional anaesthetic techniques.
我们使用商业计算机图形软件（TrueSpace）构建了一个用于教学肌间沟臂丛神经阻滞的虚拟现实模型。该工具结合了示意图的清晰度以及视频片段和现场演示的临床相关性。目的是加速学习并帮助记忆相关信息。
我们制作了一系列连续的短虚拟现实动画，展示了进行肌间沟阻滞的步骤。使浅表结构透明，以显示定位和针操作的解剖学相关性。这些片段在牛津的一个培训课程上展示给学员。对学员进行调查，以确定该展示是否增强了他们对解剖学和区域阻滞技术的理解。在展示之前和之后，学员在两名志愿者的颈部外侧和前外侧视图照片上指出表面定位、针的角度和移动。两名独立评估者对标记进行分析，并评为“好”、“差”或“无法评级”。计算每个技能组的改善百分比，并应用McNemar检验。
在24名受访者中，大多数人认为该展示增强了他们对肌间沟阻滞的解剖学（87.5%）和技术原理（79.2%）的理解。对标记照片的分析显示，教学展示后定位技能总体提高了24.1%（P<0.001）。在经验中等的技能组中变化显著（P<0.001），但在经验非常丰富的组（P>0.5）和经验不足的技能组（P<0.1）中不显著。两名评估者之间的评分一致性为76.3%。
三维动画是加速区域麻醉技术学习的一种有前景的新工具。
