Non-Fellowship regional anesthesia training and assessment: an international Delphi study on a consensus curriculum

Chuan A 1 , Jeyaratnam B 2 , Fathil S 3 , Ferraro LH 4 , Kessow A 5 , Lim YC 6 Show all authors , O'Rourke MJ 7 , Ponde V 8 , Raft J 9 , Segurado A 10 , Tangwiwat S 11 , Torborg A 12 , Turbitt L 13 , Lansdown AK 14 , Mariano ER 15 , McCartney CJ 16 , Macfarlane AJ 17 , Mok LY 18 , Orebaugh SL 19 , Pawa A 20 , Suresh S 21 , Subramanian JB 22 , Volk T 23 , Woodworth G 24 , Ramlogan R 16 , Education in Regional Anesthesia Collaboration (ERAC) Group

Affiliations 

  • 1 Department of Anaesthesia, South West Sydney Clinical School, Liverpool Hospital, University of New South Wales, Sydney, New South Wales, Australia dr.chuan@iinet.net.au
  • 2 Department of Anaesthesia, South West Sydney Clinical School, Liverpool Hospital, University of New South Wales, Sydney, New South Wales, Australia
  • 3 Department of Anaesthesia, Gleneagles Hospital Medini Johor, Johor, Malaysia
  • 4 Anesthesia and Pain, Federal University of Sao Paulo, Sao Paulo, Brazil
  • 5 Department of Anesthesia, University of Cape Town, Rondebosch, South Africa
  • 6 Department of Anaesthesia & Surgical Intensive Care, Changi General Hospital, Singapore
  • 7 Department of Anesthesiology and Perioperative Medicine, Loyola University Medical Center, Maywood, California, USA
  • 8 Department of Anaesthesia, Hinduja Health Care Surgical and Research Centre, Mumbai, India
  • 9 Department of Anesthesiology, Institut de Cancerologie de Lorraine, Vandoeuvre-les-Nancy, France
  • 10 Department of Anesthesia, Hospital Sírio-Libanês, Sao Paulo, Brazil
  • 11 Department of Anesthesiology, Mahidol University, Salaya, Thailand
  • 12 Discipline of Anaesthesiology and Critical Care, University of KwaZulu-Natal, Durban, South Africa
  • 13 Department of Anaesthesia, Belfast Health and Social Care Trust, Belfast, UK
  • 14 Department of Anaesthetics, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
  • 15 Anesthesiology and Perioperative Care Service, VA Palo Alto Health Care System, Palo Alto, California, USA
  • 16 Department of Anesthesiology and Pain Medicine, Ottawa Hospital, Ottawa, Ontario, Canada
  • 17 Department of Anaesthesia, Glasgow Royal Infirmary, Glasgow, UK
  • 18 Department of Anaesthesia and Intensive care, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
  • 19 Department of Anesthesiology, University of Pittsburgh Medical Center-Southside, Pittsburgh, Pennsylvania, USA
  • 20 Department of Anaesthesia, St Thomas' Hospital, London, UK
  • 21 Department of Pediatric Anesthesiology, Ann and Robert H. Lurie Childrens Hopsital of Chicago, Northwestern University, Chicago, Illinois, USA
  • 22 Department of Anaesthesia & Perioperative Care, Ganga Medical Centre and Hospitals Pvt Ltd, Coimbatore, India
  • 23 Department of Anaesthesiology, Intensive Care and Pain Therapy, Saarland University Hospital and Saarland University Faculty of Medicine, Homburg, Germany
  • 24 Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Portland, Oregon, USA
Reg Anesth Pain Med, 2021 10;46(10):867-873.
PMID: 34285116 DOI: 10.1136/rapm-2021-102934

Abstract

BACKGROUND AND OBJECTIVES: While there are several published recommendations and guidelines for trainees undertaking subspecialty Fellowships in regional anesthesia, a similar document describing a core regional anesthesia curriculum for non-fellowship trainees is less well defined. We aimed to produce an international consensus for the training and teaching of regional anesthesia that is applicable for the majority of worldwide anesthesiologists.

METHODS: This anonymous, electronic Delphi study was conducted over two rounds and distributed to current and immediate past (within 5 years) directors of regional anesthesia training worldwide. The steering committee formulated an initial list of items covering nerve block techniques, learning objectives and skills assessment and volume of practice, relevant to a non-fellowship regional anesthesia curriculum. Participants scored these items in order of importance using a 10-point Likert scale, with free-text feedback. Strong consensus items were defined as highest importance (score ≥8) by ≥70% of all participants.

RESULTS: 469 participants/586 invitations (80.0% response) scored in round 1, and 402/469 participants (85.7% response) scored in round 2. Participants represented 66 countries. Strong consensus was reached for 8 core peripheral and neuraxial blocks and 17 items describing learning objectives and skills assessment. Volume of practice for peripheral blocks was uniformly 16-20 blocks per anatomical region, while ≥50 neuraxial blocks were considered minimum.

CONCLUSIONS: This international consensus study provides specific information for designing a non-fellowship regional anesthesia curriculum. Implementation of a standardized curriculum has benefits for patient care through improving quality of training and quality of nerve blocks.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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