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Hands-on gel phantom and instructional video training improve sonoanatomy knowledge: A randomized controlled trial
Abstract Number: F 23
Abstract Type: Original Research
Introduction: Millions of parturients worldwide annually receive neuraxial anesthesia and analgesia.1 , Parturients with a high body mass index, difficult-to-palpate landmarks, or those with spinal abnormalities present unique challenges to anesthesiologists2. Ultrasonography has been demonstrated to improve localization of the epidural space in this patient population3, subsequently reducing needle insertion attempts and improving patient safety2. This randomized control trial evaluates two teaching modalities aimed to improve spinal sonoanatomy identification among anesthesiology faculty and residents. Results can consequently be used to improve obstetric anesthesiology education and training.
Methods: Twenty-three anesthesia residents and 27 attending anesthesiologists were randomized into gel phantom model, instructional video, and control groups. All participants attempted sonoanatomy identification on a human volunteer, both immediately after the intervention and three weeks later. Perceived knowledge, knowledge retention and participant satisfaction were evaluated using modified Likert scales.
Both interventions improved spine sonoanatomy identification accuracy compared to the control group immediately following training, but not at follow-up. Logistic regression analysis demonstrated both interventions improved the odds of transverse process (gel 12.61, p=0.013; video 7.93, p=0.030) and lamina (gel 65.12, p=0.003; video 8.97, p=0.031) identification. Perceived knowledge of basic spinal anatomy and spinal sonoanatomy improved in the intervention versus control group (Figure 1). Participants indicated high satisfaction with both teaching modalities.
Hands-on gel phantom or instructional video training can improve anesthesia faculty and resident knowledge of lumbar spine sonoanatomy. Prior studies suggest that incurred benefits from this knowledge and training include improved neuraxial needle placement3 and patient safety2. Future studies are required to assess clinical improvement, in procedural performance in parturients.
1. Osterman et al, Natl Vital Stat Rep 2011; 59: 1-13, 16
2. Faitot et al, Int J Obstet Anesth 2011; 20: 124-127
3.Grau et al, Reg Anesth Pain Med 2001; 26: 64-67