Impact of an ultrasound-guided regional anesthesia workshop on participants' confidence levels and clinical practice
Bibliographic record
Abstract
The use of ultrasound-guided regional anesthesia (UGRA) has increased, leading to a growing demand for UGRA training [1].Education may be particularly challenging for those already in established practice because educational opportunities are less obvious.In 2009, the American and European Societies of Regional Anesthesia published guidelines for training pathways in UGRA [2].For practicing anesthesiologists, they recommended workshops consisting of "didactic teaching and hands-on experience [2]." However, there is limited evidence [3] suggesting that these workshops are effective and can impact participants' clinical practice.We aimed to assess if attendance at a UGRA workshop improved confidence in block performance and impacted clinical practice.Since 2004, the regional anesthesia group at Toronto Western Hospital, University Health Network has conducted semi-annual UGRA workshops.These 2-day workshops consist of didactic lectures, live scanning of models under expert supervision, and needling practice on low fidelity simulators.The course curriculum includes teaching on upper and lower limb blocks, truncal blocks, and neuraxial ultrasound.To assess the impact of the workshop, participants were sent an online survey after completion of two courses in 2018.The primary outcome assessed with our survey was the change in participants' confidence levels post-workshop.Secondary outcomes included participants' perceptions on whether or not the workshop made a relevant impact on their clinical practice and to identify the important factors, which can increase the use of UGRA in clinical practice.Of the 99 people who participated in the two workshops, 58 (59%) responded to the follow-up survey, and 34% of the participants stated that they felt confident in performing UGRA blocks prior to attending the workshop, which increased to 66% after the workshop (P < 0.001; McNemar's test) (Fig. 1A).The major reason participants said they were not confident was the lack of needling practice (67%).Other common reasons included inadequate scanning practice (20%) and insufficient knowledge of block procedure (13%).For less experienced participants (defined as having previously performed less than 50 blocks), there was a significant increase in the percentage of participants who felt confident after the workshop.The number of confident participants in the less experienced group rose from 6% before the workshop to 61% after (P < 0.001; McNemar's test) (Fig. 1B).In contrast, more experienced participants (defined as having previously performed more than 50 blocks) showed no change in their confidence levels before and after the workshop (Fig. 1B).Most (95%) participants stated that the workshop made a relevant impact on their clin-
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.026 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.010 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".