Department of Anaesthesia, Belfast Health and Social Care Trust, Belfast, UK.
Department of Gastroenterology, Belfast Health and Social Care Trust, Belfast, UK; School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
Br J Anaesth. 2024 Aug;133(2):400-415. doi: 10.1016/j.bja.2024.04.045. Epub 2024 May 31.
Effective training in regional anaesthesia (RA) is paramount to ensuring widespread competence. Technology-based learning has assisted other specialties in achieving more rapid procedural skill acquisition. If applicable to RA, technology-enhanced training has the potential to provide an effective learning experience and to overcome barriers to RA training. We review the current evidence base for use of innovative technologies in assisting learning of RA.
Using scoping review methodology, three databases (MEDLINE, Embase, and Web of Science) were searched, identifying 158 relevant citations. Citations were screened against defined eligibility criteria with 27 studies selected for inclusion. Data relating to study details, technological learning interventions, and impact on learner experience were extracted and analysed.
Seven different technologies were used to train learners in RA: artificial intelligence, immersive virtual reality, desktop virtual reality, needle guidance technology, robotics, augmented reality, and haptic feedback devices. Of 27 studies, 26 reported a positive impact of technology-enhanced RA training, with different technologies offering benefits for differing components of RA training. Artificial intelligence improved sonoanatomical knowledge and ultrasound skills for RA, whereas needle guidance technologies enhanced confidence and improved needling performance, particularly in novices. Immersive virtual reality allowed more rapid acquisition of needling skills, but its functionality was limited when combined with haptic feedback technology. User friendly technologies enhanced participant experience and improved confidence in RA; however, limitations in technology-assisted RA training restrict its widespread use.
Technology-enhanced RA training can provide a positive and effective learning experience, with potential to reduce the steep learning curve associated with gaining RA proficiency. A combined approach to RA education, using both technological and traditional approaches, should be maintained as no single method has been shown to provide comprehensive RA training.
有效的区域麻醉(RA)培训对于确保广泛的能力至关重要。基于技术的学习方法已经帮助其他专业领域更快地掌握手术技能。如果适用于 RA,那么技术增强型培训有可能提供有效的学习体验,并克服 RA 培训的障碍。我们回顾了当前在辅助 RA 学习中使用创新技术的证据基础。
使用范围综述方法,搜索了三个数据库(MEDLINE、Embase 和 Web of Science),确定了 158 个相关引文。根据定义的入选标准筛选引文,选择了 27 项研究进行纳入。提取并分析了与研究细节、技术学习干预措施以及对学习者体验的影响相关的数据。
有七种不同的技术用于培训 RA 学习者:人工智能、沉浸式虚拟现实、桌面虚拟现实、针引导技术、机器人技术、增强现实和触觉反馈设备。在 27 项研究中,有 26 项报告了技术增强型 RA 培训的积极影响,不同的技术为 RA 培训的不同组成部分提供了益处。人工智能提高了 RA 的超声解剖学知识和超声技能,而针引导技术增强了信心,并提高了新手的进针表现。沉浸式虚拟现实允许更快地获得进针技能,但与触觉反馈技术结合使用时,其功能受到限制。用户友好的技术增强了参与者的体验并增强了对 RA 的信心;然而,RA 技术辅助培训的限制限制了其广泛使用。
技术增强型 RA 培训可以提供积极有效的学习体验,有可能减少获得 RA 熟练程度相关的陡峭学习曲线。RA 教育应采用技术和传统方法相结合的综合方法,因为没有一种方法被证明可以提供全面的 RA 培训。