American Society of Regional Anesthesia and Pain Medicine February 2018 - 24

Introduction to the Education in Regional Anesthesia Specialty
Interest Group

elen Hayes is credited with saying,
"The expert in anything was once a
beginner." Nowhere is that more true
than the specialty of regional anesthesia
(RA). The best, fastest, and safest way to
educate someone on the science and art
of RA to achieve proficiency-let alone,
expert status-is an often-debated subject
without a clear consensus. How many
blocks are necessary? What is the role of
simulation or other learning aids? What
strategy should be used: didactic, webbased, self-directed, or group learning?
These questions and others have been
investigated and considered in the
ongoing discussion of how best to educate
anesthesia trainees.1-5 Compounding
the complexity of these issues is the
advancement and restructuring of
residency training programs from a timebased model to a competency-based model
through the achievement of specific milestones.

Adam K. Jacob, MD
Associate Professor of
Anesthesiology
Mayo Clinic
Rochester, Minnesota

Technical proficiency is,
of course, only one aspect
of becoming competent in
ultrasound-guided RA (UGRA).
An equally important aspect of
educating a trainee or current
practitioner is the nontechnical
nuances of RA: judgment, patient engagement, preparation, and
follow-up. Furthermore, tracking outcomes and adverse events must
be considered in the context of an individualized learning curve as
well as ongoing practice improvement.

Reva Ramlogan, MB, BS, FRCPC
Assistant Professor of
Anesthesiology

Colin J. L. McCartney, MB, ChB,
FRCA, FRCPC
Professor and Chair of the
Department of Anesthesiology

University of Ottawa
Ottawa, Ontario, Canada
Section Editor: Kristopher Schroeder, MD

institutions, and (3) trainer and trainee characteristics or attitudes
to training in RA. Their efforts represented a significant step forward
in understanding limitations in current educational programs. The
relative ambiguity of how
best to create competent
and safe regional
anesthesiologists who
provide high-quality care
creates an opportunity to
identify the best-available
evidence in educational strategies, identify gaps in knowledge and
practice, and lead collaborative research efforts to close those gaps.

"Technical proficiency is, of course,
only one aspect of becoming competent
in ultrasound-guided RA."

Addressing those challenges in the setting of a formal, structured
anesthesia training program may be daunting. Guidelines to
advise fellowship training in RA and acute pain medicine were first
developed in 2005 and subsequently updated in 2010 and 2014.6
These guidelines provide a comprehensive framework for fellowship
programs to follow regarding organization, content, and evaluation.
However, many learners seeking training in RA have already graduated
from formal anesthesia training programs and are currently practicing.7
Whether the same educational approach can be extrapolated to
experienced, practicing clinicians interested in learning (or improving)
UGRA skills has not been investigated and remains uncertain.
In 2013, Nix and colleagues8 presented a comprehensive review of
evidence for teaching UGRA. From that, they identified three gaps
in knowledge: (1) teaching styles that lend themselves to improved
knowledge retention and performance improvement, (2) methods to
assess learners' performance that would allow comparison across

HISTORY AND STRUCTURE OF THE SPECIAL INTEREST GROUP (SIG)
Initially founded in 2016 by 26 ASRA members and led by Chair Dr
Colin McCartney and Vice-Chair Dr Reva Ramlogan, the Education in
RA SIG held its inaugural meeting at the 2017 ASRA meeting in San
Francisco. The Education in RA SIG was established with the core
mission of developing and advancing evidence-based educational
best practices in RA training in the context of a competencybased educational model. Since its inception, the membership has
grown to approximately 800 ASRA members. The SIG's goals and
objectives are the following:
1. To promote an international collaboration for the development
and advancement of assessment strategies of trainees in
evidence-based education in RA
2. To develop methodology for the evaluation of assessment tools
and simulation models, to determine the best instructional
design and learning strategies for RA
3. To advance the education and implementation of RA techniques
by anesthesiologists at all levels of training

American Society of Regional Anesthesia and Pain Medicine
2018

Table of Contents for the Digital Edition of American Society of Regional Anesthesia and Pain Medicine February 2018