WHIPPS SCANNING CLUB
Design and Implementation of a Departmental Teaching Programme to Enhance Skills in Ultrasound-guided Regional Anaesthesia
J Wong, D Wirth, S Sanapala, S Patel, C Barringer, S Chitre, G Kandasamy, S Jigajinni
Department of Anaesthesia, Whipps Cross University Hospital, Barts Health NHS Trust, London UK
Introduction and Objectives
•There has been increasing recognition of the important role Regional Anaesthesia (RA) has in patient care, theatre efficiency and healthcare economy (1-4).
•However in the UK, with the exception of dedicated RA Fellowship Programmes, training in ultrasound-guided regional anaesethsia (UGRA) occurs on an ad-hoc basis, with variable exposure on completion of training (5).
•We therefore set out to design and implement a novel, in-house rolling UGRA training programme for all anaesthetic grades at our centre – the Whipps Scanning Club (WSC).
Materials and Methods
Following approval by the Clinical Effectiveness Unit at our institution, we employed the six-step curriculum design model (5).
•A Pre-programme questionnaire was sent to the department to gauge learning needs, and preferred training programme design.
•Following pre-programme data analysis, all anaesthetists within the department were invited to attend monthly WSC sessions.
•Pre-sessional material was distributed to all pre-registered attendees.
•Delivery of WSC sessions – 5 sessions to date – Upper Limb (above clavicle), Fascia Iliaca, Abdominal Wall, Spinal Sonography, Forearm and axillary nerve block.
•Location/Time – Hospital Clinical skills lab at 5pm to minimise service impact.
•60-90-minute sessions – short presentation followed by focused scanning practice on life model stations (healthy volunteers), facilitated by expert trainers.
•Needling practice was gained with a ‘phantom meat’ station for junior attendees.
•Post-course feedback forms were distributed at the end of the sessions.
•Major finding: low departmental confidence scores in the majority of UGRA blocks, across all grades.
•Obstacles to routine UGRA practice: ‘lack of familiarity’, ‘minimal opportunities to train’ and ‘resistance from surgical colleagues’.
•Training design preference: Monthly rolling UGRA training programme – ‘for easy access’, ‘to avoid fatigue’ and ‘allow frequent exposure within a familiar environment and informal setting’.
•Session 1 - 10 attendees; Session 2 – 20 attendees; Session 3 – 10 attendees; Session 4 – 14 attendees; Session 5 – 10 attendees.
•Confidence: Improvement in scanning confidence (Fig 2) and similarly block performance confidence amongst all delegates was demonstrated after each session.
•Learning objectives and educational needs: Met for all attendees in every session (Fig 3)
•Free text feedback: ‘Hands-on practice’, ‘interactive and friendly environment’, ‘small group sizes and very relaxed’, ‘learning was embedded due to repeated regular practice’.
•The rolling in-house programme shows incredible promise in meeting UGRA educational needs within our institution.
•Using only the available on site resources, WSC is responsive to the needs of the department, and is now embedded in our monthly educational curriculum.
•Utility and confidence in UGRA has increased since programme commencement.
•Our Emergency Medicine and Orthopaedic colleagues have now requested attendance.
•We hope WSC will continue to enhance cross-speciality UGRA training in our hospital.