Regional anesthesia training model for resource-limited settings: a prospective single-center observational study with pre-post evaluations.

Autor:	Brouillette MA; Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA mark.brouillette@gmail.com.; Department of Anesthesiology, Weill Cornell Medicine, New York, New York, USA., Aidoo AJ; Directorate of Anaesthesia and Intensive Care, Komfo Anokye Teaching Hospital, Kumasi, Ghana., Hondras MA; Department of Anesthesiology, University of Kansas Medical Center, Kansas City, Kansas, USA., Boateng NA; Directorate of Anaesthesia and Intensive Care, Komfo Anokye Teaching Hospital, Kumasi, Ghana., Antwi-Kusi A; Directorate of Anaesthesia and Intensive Care, Komfo Anokye Teaching Hospital, Kumasi, Ghana.; School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana., Addison W; Directorate of Anaesthesia and Intensive Care, Komfo Anokye Teaching Hospital, Kumasi, Ghana.; School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana., Singh S; Directorate of Anaesthesia and Intensive Care, Komfo Anokye Teaching Hospital, Kumasi, Ghana.; School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana., Laughlin PT; Department of Anesthesiology, US Anesthesia Partners, Denver, Colorado, USA., Johnson B; Department of Anesthesiology, Rush University Medical Center, Chicago, Illinois, USA., Pakala SR; Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA.; Department of Anesthesiology, Weill Cornell Medicine, New York, New York, USA.
Jazyk:	angličtina
Zdroj:	Regional anesthesia and pain medicine [Reg Anesth Pain Med] 2020 Jul; Vol. 45 (7), pp. 528-535. Date of Electronic Publication: 2020 May 23.
DOI:	10.1136/rapm-2020-101550
Abstrakt:	Background and Objectives: Educational initiatives are a sustainable means to address provider shortages in resource-limited settings (RLS), yet few regional anesthesia curricula for RLS have been described. We sought to design a reproducible training model for RLS called Global Regional Anesthesia Curricular Engagement (GRACE), implement GRACE at an RLS hospital in Ghana, and measure training and practice-based outcomes associated with GRACE implementation. Methods: Fourteen of 15 physician anesthesiologists from the study location and three from an outside orthopedic specialty hospital consented to be trainees and trainers, respectively, for this prospective single-center observational study with pre-post evaluations. We conducted an initial needs assessment to determine current clinical practices, participants' learning preferences, and available resources. Needs assessment findings, expert panel recommendations, and investigator consensus were then used to generate a site-specific curriculum that was implemented during two 3-week periods. We evaluated trainee satisfaction and changes in knowledge, clinical skill, and peripheral nerve block (PNB) utilization using the Kirkpatrick method. Results: The curriculum consisted of didactic lectures, simulations, and clinical instruction to teach ultrasound-guided PNB for limb injuries. Pre-post evaluations showed trainees were satisfied with GRACE, median knowledge examination score improved from 62.5% (15/24) to 91.7% (22/24) (p<0.001), clinical examination pass rate increased from 28.6% (4/14) to 85.7% (12/14) (p<0.01), and total PNB performed in 3 months grew from 48 to 118. Conclusions: GRACE applied in an RLS hospital led to the design, implementation, and measurement of a regional anesthesia curriculum tailored to institutional specifications that was associated with positive Kirkpatrick outcomes. Competing Interests: Competing interests: None declared. (© American Society of Regional Anesthesia & Pain Medicine 2020. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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