Defining competence in obstetric epidural anaesthesia for inexperienced trainees

British Journal of Anaesthesia

Volumn 114, Issue 6, 2015, Pages 951-957

  Drake, E J ^a   Coghill, J ^a   Sneyd, J R ^a,b  

^a DERRIFORD HOSPITAL   (United Kingdom)

^b PLYMOUTH UNIVERSITY PENINSULA SCHOOLS OF MEDICINE AND DENTISTRY   (United Kingdom)

Author keywords

Anesthesia regional; Competence; Epidural; Learning curves; Obstetric

Indexed keywords

ADULT; ARTICLE; CATHETERIZATION; COMPETENCE; DATA BASE; EPIDURAL ANESTHESIA; FEMALE; HUMAN; LEARNING; LEARNING CURVE; MAJOR CLINICAL STUDY; MEDICAL STUDENT; OBSTETRIC ANESTHESIA; PRIORITY JOURNAL; PROSPECTIVE STUDY; PUBLIC HOSPITAL; WORK EXPERIENCE; ANESTHESIOLOGY; CLINICAL COMPETENCE; EDUCATION; OBSTETRICS; PREGNANCY; QUALITY CONTROL; RETROSPECTIVE STUDY; STANDARDS; TREATMENT FAILURE;

ADULT; ANESTHESIA, EPIDURAL; ANESTHESIA, OBSTETRICAL; ANESTHESIOLOGY; BENCHMARKING; CLINICAL COMPETENCE; EDUCATIONAL MEASUREMENT; FEMALE; HOSPITALS, PUBLIC; HUMANS; LEARNING CURVE; OBSTETRICS; PREGNANCY; PROSPECTIVE STUDIES; RETROSPECTIVE STUDIES; TREATMENT FAILURE;

EID: 84937965821     PISSN: 00070912     EISSN: 14716771     Source Type: Journal    
DOI: 10.1093/bja/aev064     Document Type: Article

References (25)

1. Temple PSJ. Time for Training-A Review of the impact of the European Working Time Directive on the quality of training. 2010: http://wwwmeenhsuk/PDF/14274%20Bookmark%20 Web%20Versionpdf (accessed 10 July 2014)
2. BouldMCN, Naik V. Assessment of procedural skills in anaesthesia. Br J Anaesth 2009; 103: 472-83
3. Kestin IG. A statistical approach to measuring the competence of anaesthetic trainees at practical procedures. Br J Anaesth 1995; 75: 805-9
4. Starkie T, Drake EJ. Assessment of procedural skills training and performance in anesthesia using cumulative sum analysis (cusum). Canadian Journal of Anaesthesia=Journal Canadien D'anesthesie 2013; 60: 1228-39
5. Lanigan C BR. CUSUM scoring theory and practice. Bulletin of the Royal College of Anaesthetists 2009; 54: 16-9
6. Bolsin S, Colson M. The use of the Cusum technique in the assessment of trainee competence in new procedures. International Journal for Quality in Health Care: Journal of the International Society for Quality in Health Care/ISQua 2000; 12: 433-8
7. Naik VN, Devito I, Halpern SH. Cusum analysis is a useful tool to assess resident proficiency at insertion of labour epidurals. Canadian Journal of Anaesthesia=Journal Canadien D'anesthesie 2003; 50: 694-8
8. de Oliveira Filho GR. The construction of learning curves for basic skills in anesthetic procedures: an application for the cumulative summethod. Anesthesia and Analgesia 2002; 95: 411-6
9. Barrington MJ,Wong DM, Slater B, Ivanusic JJ, Ovens M. Ultrasound-guided regional anesthesia: howmuch practice do novices require before achieving competency in ultrasound needle visualization using a cadaver model. Reg Anesth Pain Med 2012; 37: 334-9
10. Chang WR, McLean IP. CUSUM: a tool for early feedback about performance? BMC Medical Research Methodology 2006; 6: 8
11. Wong DM, Watson MJ, Kluger R, et al. Evaluation of a taskspecific checklist and global rating scale for ultrasoundguided regional anesthesia. Reg Anesth Pain Med 2014; 39: 399-408
12. Sivaprakasam J, Purva M. CUSUM analysis to assess competence: what failure rate is acceptable? The Clinical Teacher 2010; 7: 257-61
13. Sivaprakasam J, Purva M. Should OAA/RCoA provide guidelines for using CUSUM analysis to assess competence? Int J Obstet Anesth 2010; 19: S12
14. Murgatroyd H, McLure H. P57 Audit using CUSUM charts: widening repertoire of obstetric epidural. Int J Obstet Anesth 2010; 19: S43
15. Konrad C, Schupfer G, Wietlisbach M, Gerber H. Learning manual skills in anesthesiology: Is there a recommended number of cases for anesthetic procedures? Anesthesia and Analgesia 1998; 86: 635-9
16. Kopacz DJ, Neal JM, Pollock JE. The regional anesthesia 'learning curve'. What is the minimum number of epidural and spinal blocks to reach consistency? Regional Anesthesia 1996; 21: 182-90
17. Runcie CJ. Assessing the performance of a consultant anaesthetist by control chart methodology. Anaesthesia 2009; 64: 293-6
18. Steiner SH, Cook RJ, Farewell VT, Treasure T. Monitoring surgical performance using risk-adjusted cumulative sum charts. Biostatistics (Oxford, England) 2000; 1: 441-52
19. Spiegelhalter D, Grigg O, Kinsman R, Treasure T. Riskadjusted sequential probability ratio tests: applications to Bristol, Shipman and adult cardiac surgery. International Journal for Quality in Health Care: Journal of the International Society for Quality in Health Care/ISQua 2003; 15: 7-13
20. Scott NL, Lewis EJ, Murgatroyd H, Purva M. Howgood arewe at placing epidurals? Initial results from the Cusum project. Int J Obstet Anesth 2011; 20: S18
21. Crawford JS. The second thousand epidural blocks in an obstetric hospital practice. Br J Anaesth 1972; 44: 1277-87
22. Pan PH, Bogard TD, Owen MD. Incidence and characteristics of failures in obstetric neuraxial analgesia and anesthesia: a retrospective analysis of 19,259 deliveries. Int J Obstet Anesth 2004; 13: 227-33
23. Eappen S, Blinn A, Segal S. Incidence of epidural catheter replacement in parturients: a retrospective chart review. Int J Obstet Anesth 1998; 7: 220-5
24. Paech MJ, Godkin R, Webster S. Complications of obstetric epidural analgesia and anaesthesia: a prospective analysis of 10,995 cases. Int J Obstet Anesth 1998; 7: 5-11
25. Ware C-L, Oliver M, James S, Collis RE. Quality assuring an epidural service using CUSUM. International Journal of Obstetric Anesthesia 2010; 19: S47