Content area
Full Text
SUMMARY
The purpose of this study was to quantify the exposure of anaesthetic trainees to regional anaesthesia in an Australian tertiary adult teaching hospital. We reviewed data collected on all regional blocks performed by the anaesthetic department over a two-year period. The data was then broken down to give an estimate of the number of each block performed by each training year group. There was an average of 27.7 full-time equivalent trainees attached to the department. Trainees performed a total of 1374 blocks over this period. The average number of blocks performed by basic training year one trainees each year was 6.5, basic training year two trainees 13.5, advanced training year one trainees 14.9, advanced training year two trainees 19.1, advanced training year three trainees 23.1 and regional fellows 144.0. The number of total blocks and the proportion of advanced blocks increased with increasing level of training while supervision declined. Trainees in the two regional fellowship positions (7% of the trainee pool) performed 42% of the 1374 blocks. Factors that may influence the exposure of trainees to regional anaesthesia and the assessment of competency are considered.
Key Words: anaesthesia, analgesia, regional, education, training, competency
With the advent of new ultrasound technology, more accessible ultrasound machines, improved needle technology and evidence suggesting that regional anaesthesia may decrease the incidence of persistent pain1,2 or alter the course of malignant disease3 following some surgical procedures, there is an increasing interest in regional anaesthesia and analgesia techniques. This has implications for teaching hospital anaesthesia departments in teaching trainees and for assessing competency in these techniques. The aim of this study was to determine trainee experience in regional anaesthesia in a tertiary adult hospital that encourages the use of regional anaesthesia.
METHODS
Sir Charles Gairdner Hospital is a 600-bed, adult, tertiary referral, medical and surgical hospital affiliated with the University of Western Australia, providing all surgical and medical services with the exception of paediatrics and obstetrics. It is a training hospital accredited for training with the Australian and New Zealand College of Anaesthetists (ANZCA).
As part of routine patient care, data are collected on all major peripheral regional blocks performed by the anaesthesia department for individual follow-up with all patients. These data include patient demographics, identity of anaesthesia...