Core obstetric anaesthesia: A comparison of three models of training

Published Date: 15th August 2018

Publication Authors: Kennedy T

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Introduction

It has been previously documented that over 25% of anaesthetic trainees feel underprepared to enter obstetric on-calls following core obstetric anaesthesia training. The RCoA mandate that core trainees complete the Initial Assessment of Competence in Obstetric Anaesthesia before starting on-call duties. There are different ways to structure training to meet this standard. In our deanery, there are broadly three such models of training: (1) dedicated three-month block of obstetric anaesthesia at the tertiary centre; (2) three months of obstetric anaesthesia at a DGH with general oncall duties interspersed; (3) One month dedicated obstetric anaesthesia training at a DGH with no other duties. Given the variation in training models we aimed to assess trainees exposure and confidence across these three models.

Methods

A survey was sent to all trainees who had completed core anaesthetic training in the region within the last three years. The survey assessed which model of training, numbers of procedures and confidence in entering obstetric on-calls.

Results

We received 32 responses from 89 trainees. 16 trainees had been trained under model 1, nine trainees under model 2 and six trainees under model 3. One trainee did not fit under any of these headings. Unsurprisingly, those trainees who had been exposed to three months of dedicated obstetric anaesthesia training outperformed their counterparts in procedure numbers and confidence. Of the other two training models, trainees who had a one month dedicated block of obstetric anaesthesia performed more procedures and felt more prepared for starting obstetric on-calls (Fig). igure: On a scale of 1-5, how well did core obstetric anaesthesia training prepare you for obstetric on-calls?

Discussion

Our results identify a significant disparity in training exposure in core obstetric anaesthesia. Less exposure was associated with less confidence in entering obstetric on-calls. Interestingly, those trainees whose training was dedicated to obstetrics, even if for a shorter time, were more confident to enter on-call duties. This is in keeping with mastery learning principles, in which repeated deliberate practice and feedback results in improved skill acquisition and retention. The challenge is to use this data to optimise the training model.

 

Rodgers, KG; Kennedy, T; Lee, J. (2018). Core obstetric anaesthesia: A comparison of three models of training . International Journal of Obstetric Anesthesia. 35 (Suppl 1)

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