Anaesthesia
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Randomized Controlled Trial Multicenter Study
Using psychometric ability to improve education in ultrasound-guided regional anaesthesia: a multicentre randomised controlled trial.
The learning curve for novices developing regional anaesthesia skills, such as real-time ultrasound-guided needle manipulation, may be affected by innate visuospatial ability, as this influences spatial cognition and motor co-ordination. We conducted a multinational randomised controlled trial to test if novices with low visuospatial ability would perform better at an ultrasound-guided needling task with deliberate practice training than with discovery learning. Visuospatial ability was evaluated using the mental rotations test-A. ⋯ No difference was found using the global rating scale: mean (95%CI) low-ability control 53% (95%CI 46-60%); low-ability intervention 61% (95%CI 53-68%); high-ability control 63% (95%CI 56-70%); and high-ability intervention 66% (95%CI 60-72%), p = 0.05. For overall procedure pass/fail, the low-ability control group pass rate of 42% (14/33) was significantly less than the other three groups: low-ability intervention 69% (25/36); high-ability control 68% (25/37); and high-ability intervention 85% (29/34) p = 0.003. Further research is required to determine the role of visuospatial ability screening in training for ultrasound-guided needle skills.
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Multicenter Study
Addressing priorities for surgical research in Africa: implementation of a multicentre cloud-based peri-operative registry in Ethiopia.
In resource-constrained settings, where inequalities in access to and quality of surgical care results in excess mortality, peri-operative care registries are uncommon. A south-south collaboration supported the implementation of a context specific, clinician-led, multicentre real-time peri-operative registry in Ethiopia. Peri-operative information, including the Ethiopian Ministry of Health's national 'Saving Lives through Safe Surgery initiative', was linked to real-time dashboards, providing clinicians and administrators with information on service utilisation, surgical access, national surgical key performance indicators and measures of quality of care. ⋯ This collaboration has successfully implemented a multicentre digital surgical registry that can enable measurement of key performance indicators for surgery and evaluation of peri-operative outcomes. The peri-operative registry is currently being rolled out across the Amhara region and Addis Ababa city administration. It will provide continuous granular healthcare information necessary to empower clinicians to drive context-specific priorities for service improvement and research, in collaboration with national stakeholders and international research consortiums.