Regional anaesthesia training in the UK – a national survey
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Background
Adequate training of anaesthetists in regional anaesthesia is important to ensure optimal patient access to regional anaesthesia.
Methods
We undertook a national survey of UK trainee anaesthetists and Royal College of Anaesthetists (RCoA) tutors to assess experiences of training in regional anaesthesia. We performed descriptive statistics for baseline characteristics, and logistic regression of training indices and tutor confidence that their hospital could provide regional anaesthesia training at all three stages of the RCoA 2021 curriculum.
Results
A total of 492 trainees (19.2%) and 114 tutors (45.2%) completed the survey. Trainees were less likely to have received training in chest/abdominal wall compared with upper/lower limb blocks {erector spinae vs femoral block (odds ratio [OR] 0.25, 95% confidence interval [CI] 0.16–0.39), P<0.001}, or achieved >20 chest/abdominal wall blocks by Stage 3 of training (chest vs lower limb block [OR 0.09, 95% CI 0.05–0.15, P<0.001]. There was a strong association between training received, number of blocks performed (>20 vs 0–5 blocks), and self-reported ability to perform blocks independently, OR 20.9 (95% CI 9.38–53.2). 24/182 (13%) and 10/182 (5.5%) of trainees had performed ≥50 non-obstetric lumbar and thoracic epidurals, respectively, by Stage 3 training. There was a positive association between having a lead clinician for regional anaesthesia, particularly those with paid sessions, and reported confidence to provide regional anaesthesia training at all stages of the curriculum (Stage 3 OR 7.27 [95% CI 2.64–22.0]).
Conclusion
Our results confirm the importance of clinical experience and access to training in regional anaesthesia, and support the introduction of departmental regional anaesthesia leads to improve equity and quality in training opportunities.
Adequate training of anaesthetists in regional anaesthesia is important to ensure optimal patient access to regional anaesthesia.
Methods
We undertook a national survey of UK trainee anaesthetists and Royal College of Anaesthetists (RCoA) tutors to assess experiences of training in regional anaesthesia. We performed descriptive statistics for baseline characteristics, and logistic regression of training indices and tutor confidence that their hospital could provide regional anaesthesia training at all three stages of the RCoA 2021 curriculum.
Results
A total of 492 trainees (19.2%) and 114 tutors (45.2%) completed the survey. Trainees were less likely to have received training in chest/abdominal wall compared with upper/lower limb blocks {erector spinae vs femoral block (odds ratio [OR] 0.25, 95% confidence interval [CI] 0.16–0.39), P<0.001}, or achieved >20 chest/abdominal wall blocks by Stage 3 of training (chest vs lower limb block [OR 0.09, 95% CI 0.05–0.15, P<0.001]. There was a strong association between training received, number of blocks performed (>20 vs 0–5 blocks), and self-reported ability to perform blocks independently, OR 20.9 (95% CI 9.38–53.2). 24/182 (13%) and 10/182 (5.5%) of trainees had performed ≥50 non-obstetric lumbar and thoracic epidurals, respectively, by Stage 3 training. There was a positive association between having a lead clinician for regional anaesthesia, particularly those with paid sessions, and reported confidence to provide regional anaesthesia training at all stages of the curriculum (Stage 3 OR 7.27 [95% CI 2.64–22.0]).
Conclusion
Our results confirm the importance of clinical experience and access to training in regional anaesthesia, and support the introduction of departmental regional anaesthesia leads to improve equity and quality in training opportunities.
Date Issued
2023-12-01
Date Acceptance
2023-11-06
Citation
BJA Open, 2023, 8
ISSN
2772-6096
Publisher
Elsevier
Journal / Book Title
BJA Open
Volume
8
Copyright Statement
© 2023 The Authors. Published by Elsevier Ltd on behalf of British Journal of Anaesthesia. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/38089849
PII: S2772-6096(23)00120-X
Subjects
Royal College of Anaesthetists
curriculum
education
regional anaesthesia
training
Publication Status
Published
Coverage Spatial
England
Article Number
100241
Date Publish Online
2023-12-05