Expert-performance begins by focusing specifically on the end-product of training and experience in the hands of the expert. By defining expert behaviors and techniques, investigators can guide learners and non-expert practitioners by offering them models to emulate. At Toronto Western Hospital (TWH), there are more than ten expert attending regional anesthesiologists who routinely provide clinical patient care in the block room. The primary objective of this study is to qualitatively and quantitatively examine behavior of experts performing ultrasound guided regional anesthesia techniques to identify those which are consistent and unique, and which may underpin expert performance.
Study Type
OBSERVATIONAL
Enrollment
190
Qualitative behaviors of experts performing UGRA techniques during pre-procedural discussion
Reviewers will identify behaviors exhibited by the expert operators during pre-procedural discussion
Time frame: 1 hour before procedure
Qualitative behaviors of experts performing UGRA techniques during patient and equipment preparation
Reviewers will identify behaviors exhibited by the expert operators during patient and equipment preparation
Time frame: 0.5 hour before procedure
Qualitative behaviours of experts performing UGRA techniques during ultrasound scanning of the target area;
Reviewers will identify behaviors exhibited by the expert operators during ultrasound scanning of the target area;
Time frame: 10 minutes before procedure
Qualitative behaviours of experts performing UGRA techniques during needle advancement and local anesthetic deposition around the target nerve(s)
Reviewers will identify behaviors exhibited by the expert operators during needle advancement and local anesthetic deposition around the target nerve(s).
Time frame: during procedure
Quantitative data on block effectiveness defined by blocks requiring top-up
number of top-up will be collected
Time frame: 0-1 hour after procedure
Quantitative data on block effectiveness defined by blocks requiring conversion to GA
Incidence will be documented in case conversion to GA is needed
Time frame: 0-1 hour after procedure
Quantitative data on time to surgical anesthesia
defined by final needle removal to surgical anesthesia
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Time frame: 0-1 hour after procedure
Quantitative data on time to block completion
defined by needle insertion to final needle removal
Time frame: 0-1 hour after procedure