title: Teaching sonoanatomy to anesthesia faculty and residents: utility of hands-on gel phantom and instructional video training models.
abstract: OBJECTIVE
  Thousands of patients worldwide annually receive neuraxial anesthesia and analgesia. Obesity, pregnancy, and abnormal spinal anatomy pose challenges for accurate landmark palpation. Further, spinal sonoanatomy is not uniformly taught in residency education, even though its use has previously been shown to improve identification of relevant structures and decrease procedural complications and failure rates. The aim of this study was to evaluate the use of hands-on gel phantom and instructional video training for teaching spinal sonoanatomy among anesthesiology faculty and residents.
  
  
  METHODS
  Twenty-three residents and 27 anesthesiologists were randomized to gel phantom, video teaching, and control groups.
  
  
  METHODS
  Academic Hospital.
  
  
  METHODS
  Successful identification of spinal sonoanatomy was attempted on a human volunteer before and immediately after the respective intervention and 3 weeks later. Perceived knowledge and training modality satisfaction were assessed using modified Likert scales.
  
  
  METHODS
  Gel phantom and video teaching groups compared with control (no intervention).
  
  
  RESULTS
  Both interventions significantly improved spine sonoanatomy identification accuracy. Logistic regression analysis demonstrated both interventions improved the odds of transverse process (gel 12.61, P = .013; video 7.93, P = .030) and lamina (gel 65.12, P = .003; video 8.97, P = .031) identification. Perceived knowledge of basic spinal anatomy and spinal sonoanatomy improved in the intervention versus control groups. Mean (SD) modified Likert scale scores for learning satisfaction (1 = unsatisfied, 10= very satisfied) were 8.1 (1.5) and 8.0 (1.7) for hands-on gel phantom and instructional video training participants, respectively.
  
  
  CONCLUSIONS
  Use of hands-on gel phantom or instructional video training can improve anesthesia staff and resident knowledge of lumbar spine sonoanatomy.
authors.affiliation: Department of Anesthesiology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. Electronic address: bvanderw@bidmc.harvard.edu.
authors.forename: Beth A
authors.initials: BA
authors.lastname: VanderWielen
authors.affiliation: Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: Ronen
authors.initials: R
authors.lastname: Harris
authors.affiliation: Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Galgon
authors.affiliation: Department of Health Administration, Virginia Commonwealth University, Richmond, VA, USA.
authors.forename: Lynn M
authors.initials: LM
authors.lastname: VanderWielen
authors.affiliation: Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: Kristopher M
authors.initials: KM
authors.lastname: Schroeder
mesh_terms: D000328:Adult; D000775:Anesthesia, Spinal; D000776:Anesthesiology / Q000193:education*; D003198:Computer Simulation; D006801:Humans; D007396:Internship and Residency; D016015:Logistic Models; D008159:Lumbar Vertebrae / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D008875:Middle Aged; D019047:Phantoms, Imaging; D018084:Ultrasonography, Interventional; D014741:Video Recording
keywords: Anesthesia faculty and residents; Gel phantom models; Medical education; Simulation-based training; Ultrasound