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

Number of items: 13; Assessment type: behaviorally anchored
scale with dichotomous items; Clinical use: UGRA single-injection
peripheral block
Naik V, Chandra D, Chung D, Chan V. An assessment tool for brachial
plexus regional anesthesia performance: establishing construct
validity and reliability. Reg Anesth Pain Med. 2007;32(1):41-45.
Naik et al sought to validate a 20-item checklist and 8-item
global rating scale specific to nerve-stimulator-guided
interscalene brachial plexus blockade. They used a pre-existing
global rating scale with a checklist created by the modified
Delphi method. Scores of senior trainees were compared to
those of junior trainees, showing that the tool could discriminate
between the groups.
Number of items: 28; Assessment type: checklist and GRS;
Clinical use: stimulator-guided single-injection interscalene block
Sultan SF, Iohom G, Saunders J, Shorten G. A clinical assessment
tool for ultrasound-guided axillary brachial plexus block. Acta
Anaesthesiol Scand. 2012;56(5):616-623.
Sultan et al developed a 63-item checklist and 9-item global
rating scale for use in UGRA axillary brachial plexus blocks. They
used expert opinion to develop the checklist and then studied
inter-rater reliability and the tool's ability to discriminate between
providers of different skill levels.
Number of items: 72; Assessment type: checklist and GRS;
Clinical use: UGRA single-injection axillary block
Ahmed OM, O'Donnell BD, Gallagher AG, Shorten GD. Development
of performance and error metrics for ultrasound-guided axillary
brachial plexus block. Adv Med Educ Pract. 2017;8:257-263.
Ahmed et al developed a 54-item checklist and 32-item QCB tool
for UGRA single-injection axillary brachial plexus blocks. Using an
intensive Delphi method, 54 requisite steps in axillary block were
identified as well as 32 QCBs or errors. Errors were categorized
as critical or noncritical for scoring. The study only described the
tool's development and did not test its use.
Number of items: 86; Assessment type: checklist and QCB;
Clinical use: UGRA single-injection axillary block
Ahmed OMA, O'Donnell BD, Gallagher AG, et al. Construct validity
of a novel assessment tool for ultrasound-guided axillary brachial
plexus block. Anaesthesia. 2016;71(11):1324-1331.
Ahmed et al took their UGRA single-injection axillary brachial
plexus block tool and recorded a very small number of blocks

24

by experts and novices. Experts were shown to commit fewer
errors and slightly fewer critical errors (0.8 vs 1.3) compared
to novices. The inter-rater reliability between two unidentified
reviewers was very good (0.88). Times required to complete the
assessment were not recorded.
Number of items: 86; Assessment type: checklist and QCB;
Clinical use: UGRA single-injection axillary block
NEURAXIAL ANESTHESIA ASSESSMENT TOOLS
Friedman Z, Devito I, Siddiqui M, Chan V. Objective assessment of
manual skills and proficiency in performing epidural anesthesia
- video-assisted validation. Reg Anesth Pain Med. 2006;31(4):304-
310.
Friedman et al developed a 27-item checklist and 7-item global
rating scale for use in labor epidural placement. A panel of
obstetric (OB) anesthesiologists developed the assessment tool,
although development details are not disclosed. Residents were
videotaped while placing epidurals when they had performed
0-30, 31-90, and more than 90 epidural placements. The tool's
validity was suggested by the fact that higher scores correlated
to increased trainee experience. Good correlation in total scores
between raters also supported validity and reliability of the tool.
Number of items: 34; Assessment type: checklist and GRS;
Clinical use: lumbar epidural placement
Friedman Z, Siddiqui N, DeVito I. Experience is not enough: repeated
breaches in epidural anesthesia aseptic technique by novice
operators despite improved skill. Anesthesiology. 2008;108:914-
920.
Friedman et al developed a 15-item checklist for aseptic
technique during lumbar epidural placement to complement their
previously developed manual skills checklist and GRS. The sterile
technique assessment tool was employed to assess residents
with various levels of lumbar epidural experience. Progression
of manual or technical skills was shown to be faster than
progression in sterile technique.
Number of items: 15; Assessment type: checklist; Clinical use:
sterile technique during epidural placement
Birnbach DJ, Santos AC, Bourlier RA, et al. The effectiveness of
video technology as an adjunct to teach and evaluate epidural
anesthesia performance skills. Anesthesiology. 2002;96(1):5-9.
Birnbach et al developed a 33-item checklist for labor epidural
placement. Each item was assigned to one of 13 skills and
judged on whether a major error, minor error, or no error
occurred. Residents were videotaped performing blocks at

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 August 2018

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