American Society of Regional Anesthesia and Pain Medicine August 2018 - 25

the start, middle, and end of a month of OB anesthesia. Those
who were allowed to review their performance tapes showed
greater skill gains on the assessment tool than those who did
not view their performances. The tool was developed by four OB
anesthesiologists from a larger set of criteria, but the method of
tool development was not further detailed.
Number of items: 33; Assessment type: checklist; Clinical use:
lumbar epidural placement
Weed J, Finkel K, Beach ML, et al. Spinal anesthesia for orthopedic
surgery: a detailed video assessment of quality. Reg Anesth Pain
Med. 2011;36(1):51-55.
Weed et al recorded spinal anesthetics in 60 patients to
categorize the novice behavior or QCB that occurs during spinal
placement. Twelve different QCBs were identified. The study
assessed placement times, provider training level, patient
body mass index, number of needle passes, and QCB to make
meaningful correlations. Although it was not designed as an
assessment tool, the 12 QCB observed during spinal placement
are useful to know and watch for.
Number of items: 12; Assessment type: QCB; Clinical use: spinal
Breen D, Bogar L, Heigl P, Rittberger J, Shorten GD. Validation of a
clinical assessment tool for spinal anaesthesia. Acta Anaesthesiol
Scand. 2011;55(6):653-657.
Breen et al developed a tool that included 11 errors, two timemeasurement intervals, and a six-item global rating scale for
use in spinal placement. Items were developed by a consensus
of a focus group that included anesthesiologists, trainees, and
a psychologist. The errors differed from QCB in other studies
(eg, Sites et al). Breen et al had errors that were a mixture of
behaviors (doesn't palpate iliac crests) and outcomes (more than
three spaces attempted, supervisor takes over procedure). Time
measurements were T1 - positioning to + cerebrospinal fluid and
T2 - palpation to skin local. The only validity evidence for the
tool was an ability to distinguish novice, intermediate, and expert
proceduralists from one another. No ratings of interrater reliability
were performed. Time intervals did not differ significantly
between groups.

Number of items: 19; Assessment type: QCB, GRS, and time
measures; Clinical use: spinal
OTHER USEFUL MATERIALS FOR GUIDING ASSESSMENT AND
TRAINING
Chuan A, Wan AS, Royse CF, Forrest K. Competency-based
assessment tools for regional anaesthesia: a narrative review. Br J
Anaesth. 2018;120(2):264-273.
Chuan et al performed an in-depth appraisal of assessment
tools in this narrative review. Different modalities of
assessment are described, as are the principles underlying
them. The authors emphasized and provided thorough
description of the properties of an optimal tool, including
validity and reliability. Supplemental tables provide in-depth
information about the highlighted tools.
Ben-Menachem E, Ezri T, Ziv A, et al. Objective structured clinical
examination-based assessment of regional anesthesia skills: the
Israeli National Board Examination in Anesthesiology experience.
Anesth Analg. 2011;112(1):242-245.
Ben-Menachem et al described OSCE for the Israeli
Anesthesiology boards. Assessments and tasks were developed
via the Delphi method. The article presents the scoring checklist
used in an axillary block OSCE scenario. The assessment tool
was designed for a testing environment, not clinical practice, but
it can provide insight into OSCE scoring.
Sites BD, Chan VW, Neal JM, et al. The American Society of Regional
Anesthesia and Pain Medicine and the European Society of Regional
Anaesthesia and Pain Therapy joint committee recommendations
for education and training in ultrasound-guided regional anesthesia.
Reg Anesth Pain Med. 2009;34(1):40-46.
Sites et al presented ASRA/European Society of Regional
Anesthesia and Pain Therapy guidelines for UGRA training.
Although the guideline did not create or report a specific
assessment tool, it contains numerous helpful lists that can be
adapted to support procedural assessments, including 10 key
tasks for UGRA, skills associated with block proficiency, UGRA
core competencies, ultrasound curriculum maps, and stepwise
ultrasound scanning procedures.

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