Sekhavati Pooyan, Wild Tristan, Martinez Ingrid D P C, Dion Pierre-Marc, Woo Michael, Ramlogan Reva, Boet Sylvain, Shorr Risa, Gu Yuqi
Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Department of Anaesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa, ON, Canada.
Anaesthesia. 2025 May;80(5):572-581. doi: 10.1111/anae.16527. Epub 2025 Jan 6.
Ultrasound-guided regional anaesthesia enhances pain control, patient outcomes and lowers healthcare costs. However, teaching this skill effectively presents challenges with current training methods. Simulation-based medical education offers advantages over traditional methods. However, the use of instructional design features in ultrasound-guided regional anaesthesia simulation training has not been defined. This systematic review aimed to identify and evaluate the prevalence of various instructional design features in ultrasound-guided regional anaesthesia simulation training and their correlation with learning outcomes using a modified Kirkpatrick model.
A comprehensive literature search was conducted including studies from inception to August 2024. Eligibility criteria included randomised controlled trials; controlled before-and-after studies; and other experimental designs focusing on ultrasound-guided regional anaesthesia simulation training. Data extraction included study characteristics; simulation modalities; instructional design features; and outcomes.
Of the 2023 articles identified, 62 met inclusion criteria. Common simulation modalities included live-model scanning and gel phantom models. Instructional design features such as the presence of expert instructors, repetitive practice and multiple learning strategies were prevalent, showing significant improvements across multiple outcome levels. However, fewer studies assessed behaviour (Kirkpatrick level 3) and patient outcomes (Kirkpatrick level 4).
Ultrasound-guided regional anaesthesia simulation training incorporating specific instructional design features enhances educational outcome; this was particularly evident at lower Kirkpatrick levels. Optimal combinations of instructional design features for higher-level outcomes (Kirkpatrick levels 3 and 4) remain unclear. Future research should standardise outcome measurements and isolate individual instructional design features to better understand their impact on clinical practice and patient safety.
超声引导下区域麻醉可增强疼痛控制、改善患者预后并降低医疗成本。然而，采用当前的培训方法有效地教授这项技能面临挑战。基于模拟的医学教育比传统方法具有优势。然而，超声引导下区域麻醉模拟培训中教学设计特征的使用尚未明确。本系统评价旨在使用改良的柯克帕特里克模型识别和评估超声引导下区域麻醉模拟培训中各种教学设计特征的普遍性及其与学习成果的相关性。
进行了全面的文献检索，包括从起始到2024年8月的研究。纳入标准包括随机对照试验、前后对照研究以及其他专注于超声引导下区域麻醉模拟培训的实验设计。数据提取包括研究特征、模拟方式、教学设计特征和结果。
在识别出的2023篇文章中，62篇符合纳入标准。常见的模拟方式包括真人模型扫描和凝胶体模模型。诸如存在专家教员、重复练习和多种学习策略等教学设计特征很普遍，在多个结果水平上均显示出显著改善。然而，评估行为（柯克帕特里克第3级）和患者结果（柯克帕特里克第4级）的研究较少。
纳入特定教学设计特征的超声引导下区域麻醉模拟培训可提高教育效果；这在较低的柯克帕特里克水平上尤为明显。对于更高水平结果（柯克帕特里克第3级和第4级）的教学设计特征的最佳组合仍不清楚。未来的研究应标准化结果测量并分离出各个教学设计特征，以更好地了解它们对临床实践和患者安全的影响。
