Beyond the Block: Development of an Assessment Tool to Evaluate Periprocedural and Communication Skills in Regional Anesthesia.

Abstract

Background: The Objective Structured Clinical Examination (OSCE) allows for residency training programs to assess clinical competencies. OSCEs can assess periprocedural skills but are challenging to implement because of their cost and time-intensive nature, especially in subspecialty areas such as regional anesthesia. The objective of this pilot project was to develop and implement an OSCE to assess important competencies in the field of regional anesthesia with focus on periprocedural and communication skills such as the ability to obtain informed consent, select appropriate equipment, and manage complications.

Methods: Three scenarios were developed after a needs assessment of the institution's regional anesthesia curriculum. No injections were performed, and focus was given to competencies required for effective and safe regional anesthesia practice outside of procedure-specific and technical competencies. We describe the development of the scenarios, exam format, setting and performance, and development of the scoring tool. Statistical analysis was performed to evaluate the reliability of the project by measuring interrater reliability and internal consistency reliability.

Results: Three scenarios were developed with a grading tool containing 64 checklist items and 5 global rating scores. Sixty-one percent of checklist items (39 of 64) showed moderate or better interrater reliability and all global rating scores showed moderate or better agreement. All scenarios showed moderate or better internal consistency reliability.

Conclusions: This pilot project details the development of a regional anesthesia OSCE that offers a valid, reliable, reproducible, cost-effective, and feasible method to assess periprocedural and communication competencies required for successful regional anesthesia practice.