• Osman M A Ahmed, Imran Azher, Anthony G Gallagher, Dara S Breslin, Brian D O'Donnell, and George D Shorten.
• Department of Anaesthesia and Intensive Care, Midland Regional Hospital at Tullamore, Arden Road, Tullamore, Co.Offaly, Ireland. Electronic address: dr19osman@icloud.com.
• J Clin Anesth. 2018 Aug 1; 48: 22-27.

Study ObjectivesThe aim of this study was to compare the effects of deliberate vs. self-guided practices (both using validated metrics) on the acquisition of needling skills by novice learners.DesignRandomized Controlled Study.SettingSimulation lab, Department of Anesthesia, St.Vincent's Hospital, Dublin.SubjectsEighteen medical students.InterventionsStudents were assigned to either (i) deliberate practice (n = 10) or (ii) self-guided practice (n = 8) groups. After completion of a 'learning phase', subjects attempted to perform a predefined task, which entailed advancing a needle towards a target on a phantom gel under ultrasound guidance. Subsequently, all subjects practiced this task using predefined metrics. Only subjects in the deliberate practice group had an expert anesthesiologist during practice. Immediately after completing 'practice phase', all subjects attempted to perform the same task, and, on the following day, made two further attempts in succession. Two trained consultant anesthesiologists assessed a video of each performance independently using the pre-defined metrics.MeasurementsNumber of procedural steps completed and number of errors made.Main ResultsCompared with novices who self-guided their practice using metrics, those who undertook expert-supervised deliberate practice using metrics completed more steps (performance metrics) immediately after practice (median [range], 14.5 [12-15] vs. 3 [1-10], p < 0.0001) and 24 h later (15 [12-15] vs. 4.5 [1-11], p < 0.0001 and 15 [11-15] vs. 4 [2-14], p < 0.0001). They also made fewer errors immediately after practice (median [range], 0 [0-0] vs. 5 [3-8], p < 0.0001) and 24 h later, (0 [0-3] vs. 6.5 [3-8], p < 0.0001 and 0 [0-3] vs. 4 [2-7], p < 0.0001).ConclusionCombining deliberate practice with metrics improved acquisition of needling skills.Copyright © 2018 Elsevier Inc. All rights reserved.

28 keywords...

hide…