• Edward R Mariano, T Kyle Harrison, T Edward Kim, Jack Kan, Cynthia Shum, David M Gaba, Toni Ganaway, Alex Kou, Ankeet D Udani, Steven K Howard, and ADAPT (Anesthesiology-Directed Advanced Procedural Training) Research Group.
• Department of Anesthesiology, Perioperative and Pain Medicine (E.R.M., T.K.H., J.T.K., D.M.G., T.G., A.K., S.K.H.), VA Palo Alto Health Care System, Palo Alto, California USA; and Stanford University School of Medicine, Stanford, California USA; Department of Anesthesiology, Newport Harbor Anesthesia Consultants, Newport Beach, California USA (J.K.); and Department of Anesthesiology Duke University School of Medicine, Durham, North Carolina USA (A.D.U.). emariano@stanford.edu.
• J Ultrasound Med. 2015 Oct 1; 34 (10): 1883-93.

ObjectivesPracticing anesthesiologists have generally not received formal training in ultrasound-guided perineural catheter insertion. We designed this study to determine the efficacy of a standardized teaching program in this population.MethodsAnesthesiologists in practice for 10 years or more were recruited and enrolled to participate in a 1-day program: lectures and live-model ultrasound scanning (morning) and faculty-led iterative practice and mannequin-based simulation (afternoon). Participants were assessed and recorded while performing ultrasound-guided perineural catheter insertion at baseline, at midday (interval), and after the program (final). Videos were scored by 2 blinded reviewers using a composite tool and global rating scale. Participants were surveyed every 3 months for 1 year to report the number of procedures, efficacy of teaching methods, and implementation obstacles.ResultsThirty-two participants were enrolled and completed the program; 31 of 32 (97%) completed the 1-year follow-up. Final scores [median (10th-90th percentiles)] were 21.5 (14.5-28.0) of 30 points compared to 14.0 (9.0-20.0) at interval (P < .001 versus final) and 12.0 (8.5-17.5) at baseline (P < .001 versus final), with no difference between interval and baseline. The global rating scale showed an identical pattern. Twelve of 26 participants without previous experience performed at least 1 perineural catheter insertion after training (P < .001). However, there were no differences in the monthly average number of procedures or complications after the course when compared to baseline.ConclusionsPracticing anesthesiologists without previous training in ultrasound-guided regional anesthesia can acquire perineural catheter insertion skills after a 1-day standardized course, but changing clinical practice remains a challenge.© 2015 by the American Institute of Ultrasound in Medicine.

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