• Xiao Xu Chen, Vatsal Trivedi, AbdulHadi A AlSaflan, Suzanne Clare Todd, Andrea C Tricco, McCartney Colin J L CJL, and Sylvain Boet.
• From the *Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Ontario, Canada; †Department of Anesthesia and Pain Medicine, Dammam University, Dammam, Saudi Arabia; ‡Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto; §Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto; ∥Department of Anesthesiology and Pain Medicine, University of Ottawa, The Ottawa Hospital; and **Department of Innovation in Medical Education, University of Ottawa, Ottawa, Ontario, Canada.
• Reg Anesth Pain Med. 2017 Nov 1; 42 (6): 741-750.

Background And ObjectivesUltrasound-guided regional anesthesia (UGRA) has become the criterion standard of regional anesthesia practice. Ultrasound-guided regional anesthesia teaching programs often use simulation, and guidelines have been published to help guide URGA education. This systematic review aimed to examine the effectiveness of simulation-based education for the acquisition and maintenance of competence in UGRA.MethodsStudies identified in MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and ERIC were included if they assessed simulation-based UGRA teaching with outcomes measured at Kirkpatrick level 2 (knowledge and skills), 3 (transfer of learning to the workplace), or 4 (patient outcomes). Two authors independently reviewed all identified references for eligibility, abstracted data, and appraised quality.ResultsAfter screening 176 citations and 45 full-text articles, 12 studies were included. Simulation-enhanced training improved knowledge acquisition (Kirkpatrick level 2) when compared with nonsimulation training. Seven studies measuring skill acquisition (Kirkpatrick level 2) found that simulation-enhanced UGRA training was significantly more effective than alternative teaching methods or no intervention. One study measuring transfer of learning into the clinical setting (Kirkpatrick level 3) found no difference between simulation-enhanced UGRA training and non-simulation-based training. However, this study was discontinued early because of technical challenges. Two studies examined patient outcomes (Kirkpatrick level 4), and one of these found that simulation-based UGRA training improved patient outcomes compared with didactic teaching.ConclusionsUltrasound-guided regional anesthesia knowledge and skills significantly improved with simulation training. The acquired UGRA skills may be transferred to the clinical setting; however, further studies are required to confirm these changes translate to improved patient outcomes.

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