Title:  
Does high fidelity simulation training in ultrasound guided regional anaesthesia make it too difficult for novices?

Author(s):
Barnes L., Willers J., Goosen L., Rose H., Birk B., Hariharan S.

Institute(s):
Worthing Hospital, Western Sussex Hospitals NHS Foundation Trust, Dept of Anaesthesiology & Intensive Care, Worthing, United Kingdom

Text:
Background and Goal of Study: Advances in materials have made it possible to construct high fidelity simulation phantoms for ultrasound guided regional anaesthesia (USGRA). It was not known what detrimental effect greater realism and resultant increased difficulty might have on teaching these skills. We assessed this at an USGRA course using both advanced phantoms and commercial ones (Fig 1) and found this not to be the case. Users, classing themselves as experienced (n=5) or learners (n=9), responded positively (Likert scale responses >80%) . Two novices that attended gave more neutral responses ( < 80% but > 60%). It was unclear whether this was due to the level of difficulty, small sample number or unwillingness to give opinions due to inexperience (nearly 50% responses neither agree/ disagree).1 We therefore decided to test the hypothesis that increased difficulty associated with complex high fidelity USGRA phantoms could be counterproductive, and be detrimental to the learning process for novices.
Material and methods: We recruited an additional 9 novices to perform the same evaluation following exposure to an identical USGRA training process. Results were analysed in a similar manner.


Results and discussion: 
The feedback from the larger sample novices group (9) was the same in all aspects as that of the 9 (more experienced) learners (average >80%). A minority of respondents at both levels of experience felt that more realistic models were distracting and preferred basic ones, with little difference between learners and novices. This could be indicative of individual preference for a modular method of skill training instead of a holistic approach.

Conclusion: 
There do not seem to be a negative effect caused by increased realism and difficulty associated with using complex high fidelity phantoms for training USGRA training in novices, thus disproving the hypothesis.

References: 
1. Barnes L, Willers J, Rose, H, Birk, B, Goosen, L, Oosthuysen, S. Haptic realism in phantoms. A dream come true or a nightmare for learners in Ultrasound Guided Regional Anaesthesia? Anaesthesia 2015 70; 4: 29

Ethical Research Declaration: Survey

Preferred Presentation Type:  Clinical or experimental study