From the *Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, University of Ottawa, Ottawa; and †Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
Reg Anesth Pain Med. 2017 Mar/Apr;42(2):217-222. doi: 10.1097/AAP.0000000000000537.
Ultrasound assessment of the lumbar spine improves the success of spinal and epidural anesthesia, especially for patients with underlying difficult anatomy. To assist with the teaching and learning of ultrasound-guided neuraxial anesthesia, we have created an online interactive educational model (http://www.usra.ca/vspine.php and http://pie.med.utoronto.ca/vspine). The aim of the current study was to determine whether the virtual spine model improved the knowledge of neuraxial anatomy and sonoanatomy.
After obtaining ethics board approval and written participant consent, 14 anesthesia trainees with no prior experience with spine ultrasound imaging were included in this study. Construct validity was assessed using a pretest/posttest design to measure the knowledge acquired from self-study of the virtual spine simulation modules. Two tests (A and B) with 20 multiple-choice questions were used either for the pretest or posttest, at random in order to account for possible differences in difficulty between the 2 tests. These tests were administered immediately before and after a 1-hour training session using the spine ultrasound model.
Fourteen anesthesia trainees completed the study. Seven used test A as the pretest (group A), and 7 used test B as the pretest (group B). Both groups showed a statistically significant improvement (P < 0.05) in test scores after a 1-hour session with the spine ultrasound model. The mean scores were 55% (SD, 11.2%) on the pretest and 77% (SD, 8.7%) on the posttest.
The study demonstrated that after 1 hour of self-study by the trainees on the spine ultrasound model test scores improved by 40%.
腰椎超声评估可提高脊柱和硬膜外麻醉的成功率,尤其适用于存在潜在复杂解剖结构的患者。为了协助超声引导下脊柱神经阻滞的教学和学习,我们创建了一个在线互动教育模型(http://www.usra.ca/vspine.php 和 http://pie.med.utoronto.ca/vspine)。本研究旨在确定虚拟脊柱模型是否能提高对脊柱神经解剖和超声解剖的知识。
在获得伦理委员会批准和书面参与者同意后,纳入了 14 名没有脊柱超声成像经验的麻醉培训医师。采用前后测试设计评估结构效度,以衡量从虚拟脊柱模拟模块自学中获得的知识。采用 20 道多项选择题的 2 个测试(A 和 B),前测或后测中随机使用 1 个,以考虑到 2 个测试之间可能存在的难度差异。这些测试在使用脊柱超声模型进行 1 小时培训课程前后立即进行。
14 名麻醉培训医师完成了研究。7 人将测试 A 用作前测(A 组),7 人将测试 B 用作前测(B 组)。2 组在使用脊柱超声模型 1 小时课程后,测试分数均显示出统计学显著提高(P < 0.05)。前测平均分数为 55%(SD,11.2%),后测平均分数为 77%(SD,8.7%)。
本研究表明,在培训医师使用脊柱超声模型进行 1 小时自学后,测试分数提高了 40%。