Das Adhikary Sanjib, Karanzalis Demetrius, Liu Wai-Man Raymond, Hadzic Admir, McQuillan Patrick M
Department of Anesthesiology and Perioperative Medicine, Penn State College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA.
Research School of Finance, Actuarial Studies and Applied Statistics, The Australian National University, Acton, Australia.
Pain Med. 2017 May 1;18(5):856-865. doi: 10.1093/pm/pnw287.
To evaluate the effectiveness of a new learning tool for needle insertion accuracy skills during a simulated ultrasound-guided regional anesthesia procedure.
Thirty participants were included in this randomized controlled study. After viewing a prerecorded video of a single, discreet, ultrasound-guided regional anesthesia task, all participants performed the same task three consecutive times (pretest), and needle insertion accuracy skills in a phantom model were recorded as baseline. All participants were then randomized into two groups, experimental and control. The experimental group practiced the task using the new tool, designed with two video cameras, a monitor, and an ultrasound machine where the images from the ultrasound and video of hand movements are viewed simultaneously on the monitor. The control group practiced the task without using the new tool. After the practice session, both groups repeated the same task and were evaluated in the same manner as in the pretest.
Participants in both group groups had similar baseline characteristics with respect to previous experience with ultrasound-guided regional anesthesia procedures. The experimental group had significantly better needle insertion accuracy scores ( P < 0.01) than the control group. Using the new learning tool, inexperienced participants had better needle insertion accuracy scores ( P < 0.01) compared with experienced participants.
This study demonstrates that the use of this new learning tool results in short-term improvement in hand-eye, motor, and basic needle insertion skills during a simulated ultrasound-guided regional anesthesia procedure vs traditional practice methods. Skill improvement was greater in novices compared with experienced participants.
评估一种新型学习工具在模拟超声引导区域麻醉操作中对进针准确性技能的有效性。
本随机对照研究纳入了30名参与者。在观看一段预先录制的单一、离散的超声引导区域麻醉任务视频后，所有参与者连续三次执行相同任务（预测试），并将在模拟模型中的进针准确性技能记录为基线。然后，所有参与者被随机分为两组，即实验组和对照组。实验组使用新工具练习该任务，新工具配备两个摄像机、一个显示器和一台超声机器，超声图像和手部动作视频可在显示器上同时查看。对照组在不使用新工具的情况下练习该任务。练习环节结束后，两组重复相同任务，并以与预测试相同的方式进行评估。
两组参与者在超声引导区域麻醉操作的既往经验方面具有相似的基线特征。实验组的进针准确性得分显著高于对照组（P < 0.01）。使用新学习工具时，无经验的参与者与有经验的参与者相比，进针准确性得分更高（P < 0.01）。
本研究表明，与传统练习方法相比，在模拟超声引导区域麻醉操作中使用这种新型学习工具可在短期内改善手眼协调、运动和基本进针技能。新手的技能提升比有经验的参与者更大。
