The use of an online three-dimensional model improves performance in ultrasound scanning of the spine: A randomized trial

Abstract

Purpose The use of ultrasound for neuraxial blockade is a new application of technology that is rapidly becoming accepted as a standard of care. This new skill has shown to improve success, but it is a challenge to teach. To assist with teaching the use of ultrasound in regional anesthesia of the lumbar spine, we have developed an interactive educational model (http://pie.med.utoronto.ca/ vspine or http://www.usra.ca/vspine.php). In this study, we aimed to determine whether use of this model for a two-week period would improve the performance of novice operators in determining defined landmarks during real-time ultrasound imaging of the lumbar spine. Methods We evaluated the educational benefit of the ultrasound module by randomly assigning 16 postgraduate firstyear (PGY1) anesthesia residents to either a control groupwith password-protected access to only the lumbar anatomy module or to an intervention group with access to the complete module. All residents had access to the module for two weeks following a full-day workshop that is part of the university teaching program which consists of a didactic lecture on ultrasoundfacilitated neuraxial anesthesia, mentored teaching on cadaveric spine dissections, and hands-on ultrasound scanning of livemodels. At the end of the two weeks, the performance of the residents was evaluated using a 12-item task-specific checklist while carrying out a scout scan on a live model. Results The control group had a median score of 5.5 (25th percentile: 4, 75th percentile: 18), while the intervention group had a median score of 11.5 (25th percentile: 8, 75th percentile: 12) in the task-specific checklist, with a significant difference of 6 (confidence interval 1.5 to 10.5) between groups (P = 0.021). Conclusion Our results show superior performance by the residents who had access to both components of the module, indicating that access to the interactive ultrasound spine module improves knowledge and skills prior to clinical care. © Canadian Anesthesiologists' Society 2013.