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DEVELOPMENT OF AN OBJECTIVE MEASURE OF INTERSCALENE BLOCK COMPETENCY USING EYE TRACKING IN A MASTERY LEARNING AND DEDICATEDPRACTICE ENVIRONMENT
ESRA Academy. Ayman M. Sep 8, 2016; 138561
Topic: Peripheral Nerve Blocks
Disclosure(s): Nothing to disclose
Dr. Mustafa Ayman
Dr. Mustafa Ayman

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Abstract
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Background and Aims:

Ultrasound-guided regional anaesthesia (UGRA) is difficult to learn and the psychological mechanisms underpinning clinical proficiency remain poorly understood. Despite a proliferation of short UGRA training courses, very little medical education evidence exists to guide trainers. Mastery learning is an educational paradigm used successfully to train technical skills particularly when combined with dedicated practice - the formal repetition of procedures allied to expert feedback and debriefing. Our primary objective was to develop an objective learning curve using eye tracking glasses, while using mastery learning and dedicated practice on a soft embalmed cadaver simulator. Secondary objectives were to measure self-efficacy before and after each block.

Methods:

After Ethics Committee approval and signed consent, 28 anaesthesia trainees performed up to 60 interscalene UGRA blocks over three hours on a single soft embalmed Thiel human cadaver. Eye movements were monitored in real-time using SensoMotoric Instruments (SMI) mobile eye tracking glasses . Eleven performed 20 blocks at 4 month follow up. Four experts performed 20 blocks. Pre and post-test self-report confidence and pre-test anxiety were measured on a 10-point rating scale. Eye movement measures included fixation count and dwell time, shifts in attention (glance count) and scan path distribution.

Results:

There was reduction over time in pre-procedural and procedural task completion. Eye gaze metrics reduced over time, Experts exhibited significantly fewer fixations than novices across blocks, indicating a greater focus of attention. On re-testing 80% of trainees had reduction on fixation count.

Conclusions:

We developed an objective UGRA assessment tool using eye tracking technology within a mastery learning.

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