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A Structured Method of Teaching Epidural Block reduces the incidence of accidental dural puncture in inexperienced trainees.
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作者 Marco Scorzoni Gianluigi Gonnella +4 位作者 emanuele capogna Marina Campione Gaetano Draisci Matteo Velardo Giorgio capogna 《Open Journal of Anesthesiology》 2024年第4期131-135,共5页
Background: The rate of accidental dural puncture is particularly high during the period of training, especially in novices. The structured epidural teaching model (SETM) includes three standardized video lessons, the... Background: The rate of accidental dural puncture is particularly high during the period of training, especially in novices. The structured epidural teaching model (SETM) includes three standardized video lessons, the construction of a 3D epidural module by trainees and practical training by using an epidural simulator with and without the CompuFlo™ Epidural instrument. In this study we report the retrospective analysis of the accidental dural puncture rate of inexperienced trainees during their 6 months clinical practice rotation in obstetrics before and after the introduction of the SETM in our Institution. Method: We evaluated the incidence of accidental dural puncture before the introduction of the SETM methodology and afterwards by analyzing our departmental database from February 2019 to January 2023. All epidural blocks were executed by trainees who had never previously performed an epidural block and were about to begin their obstetrics rotation. Results: We analyzed 7415 epidurals: 3703 were performed before the introduction of the SETM methodology (control group) and 3712 afterwards (study group). The incidence of accidental dural puncture was 0.37% for the control group and 0.13% for the study group (p<.05). The probability of making an accidental dural puncture was 64% (OR: 0.36) lower for trainees who had the training than for those who did not. Conclusions: After the introduction of the structured teaching method, we observed a significant reduction of accidental dural puncture during the training period. We hope that our observation will encourage a constructive discussion among experts about the need to use standardized and validated tools as a valuable aid in teaching epidural anesthesia. 展开更多
关键词 TEACHING epidural Anesthesia obstetrical Anesthesia ANESTHESIA
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Eye Movement Modeling Examples as a Teaching Tool for Epidural Block
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作者 emanuele capogna Marco Scorzoni +5 位作者 Gian Luigi Gonnella Matteo Velardo Pier Paolo Giurì Mariano Ciancia Gaetano Draisci Giorgio capogna 《Open Journal of Anesthesiology》 2023年第4期75-84,共10页
Introduction: Video examples with task demonstrations by experts, with the expert’s eye movements superimposed on the task, are known as “eye movement modeling examples” (EMME). We performed this study to evaluate ... Introduction: Video examples with task demonstrations by experts, with the expert’s eye movements superimposed on the task, are known as “eye movement modeling examples” (EMME). We performed this study to evaluate if there were improvements in the performance of anesthesia novice trainees when executing the epidural technique after an EMME of epidural block procedure. Methods: We developed an eye movement modeling example (EMME) from eye tracking recordings made by experienced anesthesiologists with more than 20 years of experience. Forty-two PGY3 anesthesia trainees who had never previously performed an epidural block were randomized to receive (study group) or not receive (control group) the EMME video before their institutional training. All the trainees were evaluated every 10 epidural blocks until the end of the rotation period, by an independent, blinded observer using the Global Rating Scale for Epidural Anesthesia (GRS). Results: Trainees who received the EMME training exhibited more respect for the patient’s tissues (P Discussion: This is the first study that has used the EMME for a practical, clinical teaching purpose on real patients and that has used it as an aid in teaching epidural anesthesia. We demonstrated that inexperienced trainees who received the EMME training improved their proficiency at epidural blocks as compared to those who had no EMME training beforehand. Given this result, we welcome further studies to investigate the impact and the role of EMME on clinical teaching in the field of anesthesia. 展开更多
关键词 Eye Tracking Eye Movement Modeling Example Epidural Anesthesia
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Changes in Gaze Behavior during the Learning of the Epidural Technique with a Simulator in Anesthesia Novices
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作者 emanuele capogna Francesco Salvi +2 位作者 Angelica Del Vecchio Matteo Velardo Giorgio capogna 《Open Journal of Anesthesiology》 2020年第11期361-370,共10页
<b><span style="font-family:Verdana;">Background: </span></b><span style="font-family:Verdana;">Current literature demonstrates the ability of eye tracking to provide ... <b><span style="font-family:Verdana;">Background: </span></b><span style="font-family:Verdana;">Current literature demonstrates the ability of eye tracking to provide reliable quantitative data as an objective assessment tool, with potential applications to medical and surgical training to improve performance.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Objective: </span></b><span style="font-family:Verdana;">The aim of this study was to evaluate the changes in gaze behavior in anesthesia novice trainees when performing a simulated epidural technique before and after a hands-on training on the epidural simulator.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">We enrolled 48 novice trainees who had never previously performed an epidural block. After a standardized learning module, each trainee practiced the epidural procedure on the epidural simulator while wearing a pair of eye tracking glasses (Tobii Pro Glasses 50 Hz wearable wireless eye tracker). After this baseline recording, each trainee spent two hours practicing with the epidural simulator and afterwards once again performed the eye tracking epidural procedure.</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">Eye tracking metrics and epidural learning (duration of the procedure and number of attempts) before and after the simulated practice were recorded.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The duration of the epidural procedure and of the epidural needle advancement phase (P < </span><span style="font-family:Verdana;">0</span><span style="font-family:Verdana;">.05) and the number of epidural attempts (P < </span><span style="font-family:Verdana;">0</span><span style="font-family:Verdana;">.001) were reduced after the tutorial.</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">When considering the eye tracking metrics, after the tutorial</span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> the number of visit counts decreased and their duration increased (P < </span><span style="font-family:Verdana;">0</span><span style="font-family:Verdana;">.05). The number of epidural needle insertions (additional attempts) showed a significant positive correlation with the visits number (aOR = 2.02 (95% CI = 1.26</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">3.55;P = </span><span style="font-family:Verdana;">0</span><span style="font-family:Verdana;">.008)) and a significant negative correlation with the visit duration (aOR = 0.65 (95% CI = 0.39</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">0.99;P = </span><span style="font-family:Verdana;">0</span><span style="font-family:Verdana;">.05)). </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">We observed significant changes in gaze behavior associated with increased performance during the epidural technique learning with a simulator in anesthesia trainees who had never previously performed an epidural block.</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">These results may create a prototype for future studies on eye tracking technique as a teaching and evaluating tool in simulation.</span> 展开更多
关键词 Simulation Epidural Technique Eye Tracking
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