PubMed Health⌕ Search

PubMed · 17196491

An assessment tool for brachial plexus regional anesthesia performance: establishing construct validity and reliability.

Abstract

BACKGROUND AND OBJECTIVES: Technical proficiency in regional anesthesia is often determined subjectively through in-training evaluations. Objective assessment tools improve these evaluations by providing criteria for measurement. However, any evaluation instrument needs to be valid and reliable before it is adopted into a curriculum. The purpose of this study is to determine the validity and reliability of a devised assessment of residents performing an interscalene brachial plexus block (ISB). METHODS: In this prospective study, 10 junior trainees and 10 senior trainees were videotaped performing an ISB. Junior trainees were defined as in their first year of anesthetic training and had performed less than 10 ISBs independently. Senior trainees had completed at least 1 year of anesthesia training and had performed greater than 10 ISBs independently. Two blinded expert raters independently evaluated the performance of the ISB using a checklist and global rating scale. Construct validity was established if the assessments were able to reliably discriminate between different levels of training. RESULTS: Senior trainees performed an ISB significantly better than junior trainees when assessed using the global rating scale (P < .05) and checklist (P < .001). The overall interrater reliability for the global rating scores was excellent (r = 0.85, P < .05) and was good for the checklist scores (r = 0.74, P < .05). CONCLUSIONS: Both assessment modalities were valid, in that they reliably discriminated between different levels of training. Objective measures of technical skills are feasible, timely, and improve the validity and reliability of competency assessments.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

Viren N Naik, Anahi Perlas, Deven B Chandra, David Y Chung, Vincent W S Chan. An assessment tool for brachial plexus regional anesthesia performance: establishing construct validity and reliability.. https://doi.org/10.1016/j.rapm.2006.10.009

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Regional versus general anaesthesia for caesarean section.

BACKGROUND: Regional and general anaesthesia (GA) are commonly used for caesarean section (CS) and both have advantages and disadvantages. It is important to clarify what type of anaesthesia is more efficacious. OBJECTIVES: To compare the effects of regional anaesthesia (RA) with those of GA on the outcomes of CS. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 December 2005), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2005, Issue 1), MEDLINE (1966 to December 2005), and EMBASE (1980 to December 2005). SELECTION CRITERIA: Randomised and quasi-randomised controlled trials evaluating the use of RA and GA in women who had CS for any indication. DATA COLLECTION AND ANALYSIS: Two authors independently assessed trials for inclusion, data extraction and trial quality. MAIN RESULTS: Sixteen studies (1586 women) were included in this review. Women who had either epidural anaesthesia or spinal anaesthesia were found to have a significantly lower difference between pre and postoperative haematocrit (weighted mean difference (WMD) 1.70, 95% confidence interval (CI) 0.47 to 2.93, one trial, 231 women) and (WMD 3.10, 95% CI 1.73 to 4.47, one trial, 209 women). Compared to GA, women having either an epidural anaesthesia or spinal had a lower estimated maternal blood loss (WMD -126.98 millilitres, 95% CI -225.06 to -28.90, two trials, 256 women) and (WMD -84.79 millilitres, 95% CI -126.96 to -42.63, two trials, 279 women). More women preferred to have GA for subsequent procedures when compared with epidural (odds ratio (OR) 0.56, 95% CI 0.32 to 0.96, one trial, 223 women) or spinal (OR 0.44, 95% CI 0.24 to 0.81, 221 women). The incidence of nausea was also less for this group of women compared with epidural (OR 3.17, 95% CI 1.64 to 6.14, three trials, 286 women) or spinal (OR 23.22, 95% CI 8.69 to 62.03, 209 women). No significant difference was seen in terms of neonatal Apgar scores of six or less and of four or less at one and five minutes and need for neonatal resuscitation with oxygen. AUTHORS' CONCLUSIONS: There is no evidence from this review to show that RA is superior to GA in terms of major maternal or neonatal outcomes. Further research to evaluate neonatal morbidity and maternal outcomes, such as satisfaction with technique, will be useful.

Anesthesia, Conduction↗

[Perineal regional anaesthesia: indications in gynaecologic and proctologic surgery and in obstetric].

Perineal and proctologic surgery is well known as very painful. The apparition of new specific needles, long acting and less toxic local anaesthetics and neurostimulation allowed reconsidering some old forgotten techniques. Those blocks appear really useful to optimize multimodal postoperative analgesia and postoperative rehabilitation. After anatomic review, authors describe perineal regional anaesthesia and discuss about main indications and advantages, in the eyes of their experience and bibliographic review.

Anesthesia, Conduction↗