Niazi Ahtsham U, Peng Philip W, Ho Melissa, Tiwari Akhilesh, Chan Vincent W
Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada.
Can J Anaesth. 2016 Aug;63(8):966-72. doi: 10.1007/s12630-016-0653-7. Epub 2016 Apr 12.
Application of ultrasound in regional anesthesia has now become the standard of care and its use has shown to reduce complications. Nevertheless, gaining expertise in ultrasound-guided regional anesthesia requires the acquisition of new cognitive and technical skills. In addition, due to a reduction in resident working hours and enforcement of labour laws and directives across various states and countries, trainees perform and witness fewer procedures. Together, these issues create challenges in the teaching and learning of ultrasound-guided regional anesthesia in the time-based model of learning.
The challenges of teaching ultrasound-guided regional anesthesia are similar to those experienced by our surgical counterparts with the advent of minimally invasive surgery. In order to overcome these challenges, our surgical colleagues used theories of surgical skills training, simulation, and the concept of deliberate practice and feedback to shift the paradigm of learning from experience-based to competency-based learning.
In this narrative review, we describe the theory behind the evolution of surgical skills training. We also outline how we can apply these learning theories and simulation models to a competency-based curriculum for training in ultrasound-guided regional anesthesia.
超声在区域麻醉中的应用现已成为标准治疗手段,且已证明其使用可减少并发症。然而,要掌握超声引导下区域麻醉的专业技能,需要获得新的认知和技术能力。此外,由于住院医师工作时间减少以及各国和各地区劳动法和指令的实施,实习生进行和观摩的操作较少。这些问题共同给基于时间的学习模式下超声引导区域麻醉的教学带来了挑战。
超声引导区域麻醉教学面临的挑战与微创手术出现后外科同行所经历的挑战类似。为了克服这些挑战,我们的外科同事运用手术技能培训理论、模拟以及刻意练习和反馈的概念,将学习模式从基于经验的学习转变为基于能力的学习。
在这篇叙述性综述中,我们描述了手术技能培训演变背后的理论。我们还概述了如何将这些学习理论和模拟模型应用于基于能力的超声引导区域麻醉培训课程。