A comprehensive description of the competencies required for the performance of an ultrasound-guided axillary brachial plexus blockade

We addressed four research questions, each relating to the training and assessment of the competencies associated with the performance of ultrasound-guided axillary brachial plexus blockade (USgABPB). These were: (i) What are the most important determinants of learning of USgABPB? (ii) What is USgABPB? What are the errors most likely to occur when trainees learn to perform this procedure? (iii) How should end-user input be applied to the development of a novel USgABPB simulator? (iv) Does structured simulation based training influence novice learning of the procedure positively? We demonstrated that the most important determinants of learning USgABPB are: (a) Access to a formal structured training programme. (b) Frequent exposure to clinical learning opportunity in an appropriate setting (c) A clinical learning opporunity requires an appropriate patient, trainee and teacher being present at the same time, in an appropriate environment. We carried out a comprehensive description of the procedure. We performed a formal task analysis of USgABPB, identifying (i) 256 specific tasks associated with the safe and effective performance of the procedure, and (ii) the 20 most critical errors likely to occur in this setting. We described a methodology for this and collected data based on detailed, sequential evaluation of prototypes by trainees in anaesthesia. We carried out a pilot randomised control trial assessing the effectiveness of a USgABPB simulator during its development. Our data did not enable us to draw a reliable conclusion to this question; the trail did provide important new learning (as a pilot) to inform future investigation of this question. We believe that the ultimate goal of designing effective simulation-based training and assessment of ultrasound-guided regional anaesthesia is closer to realisation as a result of this work. It remains to be proven if this approach will have a positive impact on procedural performance, and more importantly improve patient outcomes.

“It’s just like passing notes in class…”: a content analysis of the use of Twitter at #asl2015

Twitter has changed the dynamic of the academic conference. Before Twitter, delegate participation was primarily dependent on attendance and feedback was limited to post-event survey. With Twitter, delegates have become active participants. They pass comment, share reactions and critique presentations, all the while generating a running commentary. This study examines this phenomenon using the Academic & Special Libraries (A&SL) conference 2015 (hashtag #asl2015) as a case study. A post-conference survey was undertaken asking delegates how and why they used Twitter at #asl2015. A content and conceptual analysis of tweets was conducted using Topsy and Storify. This analysis examined how delegates interacted with presentations, which sessions generated most activity on the timeline and the type of content shared. Actual tweet activity and volume per presentation was compared to survey responses. Finally, recommendations on Twitter engagement for conference organisers and presenters are provided.