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Determinants of learning to perform spinal anaesthesia: a pilot study

Kulcsar, Z.*; Aboulafia, A.; Hall, T.; Shorten, G. D.*

European Journal of Anaesthesiology (EJA): December 2008 - Volume 25 - Issue 12 - p 1026-1031
doi: 10.1017/S0265021508004535
Original Article

Background and objective: This study examined attitudes and views held by stakeholders regarding their experience of training in spinal anaesthesia. The aim was to identify key factors related to learning and teaching processes which were perceived to influence the acquisition of competence in spinal anaesthesia.

Methods: The study was carried out at a busy acute tertiary referral teaching hospital over a period of 1 yr. It applied a qualitative research approach in three phases, namely (i) completion of preliminary questionnaires, (ii) completion of focused questionnaires and (iii) focus group discussions.

Results: Five factors were perceived to be critical ‘determinants of learning': (i) the existence of a formal, structured training programme; (ii) time constraints/theatre efficiency; (iii) trainer-trainee interaction; (iv) patient safety/trainee/trainer stressors; and (v) visualization of the anatomy and procedure.

Conclusion: The study highlighted the need for a formal and structured training programme in spinal anaesthesia, through which many of the undesirable and discouraging factors (such as stress, adverse trainer-trainee interaction and time constraints) identified in the study could be minimized. Further studies are needed to validate the results in other hospital settings, as well as to define the relative importance of each of the proposed determinants and their interrelationships.

* Cork University Hospital, Department of Anaesthesia and Intensive Care Medicine, Cork, Galway, Ireland

University of Limerick, Interaction Design Centre, Limerick, Galway, Ireland

National University of Ireland, School of Education, Galway, Ireland

Correspondence to: Zsuzsanna Kulcsar, Department of Anaesthesia and Intensive Care Medicine, Cork University Hospital, Wilton, Cork, Ireland. E-mail:; Tel: +353 87 0524270; Fax: +353 21 4546434

Accepted for publication 27 April 2008

First published online 5 June 2008

© 2008 European Society of Anaesthesiology