Ardon Alberto, Bojaxhi Elird, Clendenen Steven, McClain Robert, Gillespie Nigel, Robards Christopher, Greengrass Roy
Anesthesiology, Mayo Clinic, Jacksonville, USA.
Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, USA.
Cureus. 2023 Apr 20;15(4):e37869. doi: 10.7759/cureus.37869. eCollection 2023 Apr.
Introduction Variability regarding which blocks are performed most often can be quite high among anesthesiology residency training programs. Which techniques are viewed by residency programs as "critical" for their graduates to know can also be inconsistent. We administered a national survey to investigate correlations between the cited importance of techniques and the relative frequency with which they are being taught. Materials and methods A three-round modified Delphi method was used to develop the survey. The final survey was sent to 143 training programs across the United States. The surveys collected information on the frequency with which thoracic epidural blocks, truncal blocks, and peripheral blocks were taught. The respondents were also asked to rate how critical each technique is to learn during residency. A correlation between the relative frequency of block teaching and cited importance to education was calculated using Kendall's Tau statistic. Results Among truncal procedures, transversus abdominis plane (TAP) block and thoracic epidural blocks were frequently viewed as "indispensable for daily practice." Among peripheral nerve blocks, interscalene, supraclavicular, adductor, and popliteal blocks were frequently viewed as indispensable. All truncal blocks showed a strong correlation between the relative frequency of block teaching and cited importance to education. However, the frequency of teaching interscalene, supraclavicular, femoral, and popliteal blocks failed to correlate with their reported importance ranking. Conclusions Perceived importance was significantly associated with the reported frequency of block teaching for all truncal and peripheral blocks except for interscalene, supraclavicular, femoral, and popliteal. The lack of correlation between the frequency of teaching and perceived importance is reflective of a changing educational landscape.
引言 在麻醉学住院医师培训项目中,关于哪些阻滞操作最常被执行的差异可能相当大。住院医师培训项目认为哪些技术对其毕业生来说是“关键”的,也可能不一致。我们进行了一项全国性调查,以研究技术的重要性与教学相对频率之间的相关性。
材料与方法 采用三轮改进的德尔菲法开展调查。最终调查问卷发送给了美国各地的143个培训项目。这些调查收集了关于胸段硬膜外阻滞、躯干阻滞和外周阻滞教学频率的信息。还要求受访者对每项技术在住院医师培训期间学习的关键程度进行评分。使用肯德尔tau统计量计算阻滞教学相对频率与教育重要性之间的相关性。
结果 在躯干阻滞操作中,腹横肌平面(TAP)阻滞和胸段硬膜外阻滞常被视为“日常实践中不可或缺的”。在外周神经阻滞中,肌间沟、锁骨上、内收肌和腘窝阻滞常被视为不可或缺。所有躯干阻滞在阻滞教学相对频率与教育重要性之间均显示出强相关性。然而,肌间沟、锁骨上、股部和腘窝阻滞的教学频率与其报告的重要性排名不相关。
结论 除肌间沟、锁骨上、股部和腘窝阻滞外,所有躯干和外周阻滞的感知重要性与报告的阻滞教学频率显著相关。教学频率与感知重要性之间缺乏相关性反映了教育格局的变化。