@文章{信息:doi/10.2196/32840，作者=“McLeod, Graeme和McKendrick, Mel和Tafili, Tedis和Obregon, Mateo和Neary, Ruth和Mustafa, Ayman和Raju, Pavan和Kean, Donna和McKendrick, Gary和McKendrick，周二”，标题=“麻醉医师在软尸体上模拟斜角间块训练时的技能习得模式:队列研究”，期刊=“JMIR Med Educ”，年=“2022”，月=“8”，日=“11”，卷=“8”，数=“3”，页=“e32840”，关键词=“区域麻醉”;超声;模拟;学习曲线;背景:大手术对区域麻醉的需求大幅增加，但只有少数麻醉师能够提供这种护理。模拟可以改善临床表现。然而，排练手术的机会有限，而且皇家麻醉师学院2021年培训课程规定的临床教育成果很难达到。教育模式，如掌握学习和专门实践，正越来越多地用于教授技术技能，以提高技能的获得。此外，高保真、有弹性的尸体模拟器现在已经可用:柔软的防腐蒂尔尸体显示出与患者相似的物理特征和功能排列。 Tissue elasticity allows tissues to expand and relax, fluid to drain away, and hundreds of repeated injections to be tolerated without causing damage. Learning curves and their intra- and interindividual dynamics have not hitherto been measured on the Thiel cadaver simulator using the mastery learning and dedicated practice educational paradigm coupled with validated, quantitative metrics, such as checklists, eye tracking metrics, and self-rating scores. Objective: Our primary objective was to measure the learning slopes of the scanning and needling phases of an interscalene block conducted repeatedly on a soft embalmed Thiel cadaver over a 3-hour period of training. Methods: A total of 30 anesthesiologists, with a wide range of experience, conducted up to 60 ultrasound-guided interscalene blocks over 3 hours on the left side of 2 soft embalmed Thiel cadavers. The duration of the scanning and needling phases was defined as the time taken to perform all the steps correctly. The primary outcome was the best-fit linear slope of the log-log transformed time to complete each phase. Our secondary objectives were to measure preprocedural psychometrics, describe deviations from the learning slope, correlate scanning and needling phase data, characterize skills according to clinical grade, measure learning curves using objective eye gaze tracking and subjective self-rating measures, and use cluster analysis to categorize performance irrespective of grade. Results: The median (IQR; range) log-log learning slopes were −0.47 (−0.62 to −0.32; −0.96 to 0.30) and −0.23 (−0.34 to −0.19; −0.71 to 0.27) during the scanning and needling phases, respectively. Locally Weighted Scatterplot Smoother curves showed wide variability in within-participant performance. The learning slopes of the scanning and needling phases correlated: $\rho$=0.55 (0.23-0.76), P<.001, and $\rho$=−0.72 (−0.46 to −0.87), P<.001, respectively. Eye gaze fixation count and glance count during the scanning and needling phases best reflected block duration. Using clustering techniques, fixation count and glance were used to identify 4 distinct patterns of learning behavior. Conclusions: We quantified learning slopes by log-log transformation of the time taken to complete the scanning and needling phases of interscalene blocks and identified intraindividual and interindividual patterns of variability. ", issn="2369-3762", doi="10.2196/32840", url="https://mededu.www.mybigtv.com/2022/3/e32840", url="https://doi.org/10.2196/32840", url="http://www.ncbi.nlm.nih.gov/pubmed/35543314" }