#36101 Training in plan A blocks – a regional trainee survey and quality improvement project

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Background and Aims

The importance of regional anaesthesia (RA) training has recently been recognised by changes to the RCoA curriculum. Where previously trainees could finish training without necessarily achieving competency in ‘Plan A’ blocks, the requirement now is to perform these blocks independently and to manage any complications. We surveyed the confidence of current West Midlands anaesthesia trainees in Plan A blocks and explored what barriers are encountered in their training.

Methods

An anonymised survey was emailed to West Midlands anaesthetic trainees recording stage of training, awareness of Plan A blocks, level of experience in these, and barriers to training in RA.

Results

A total of 51 trainees responded. Only 62% were aware of the concept of Plan A blocks. Exposure was greatest for upper limb blocks, and was particularly low for rectus sheath and erector spinae blocks. Almost all senior trainees undertaking advanced training in RA were confident performing blocks independently. This contrasts with only 20% of Stage 3, and no Stage 1-2 trainees. The most common barriers to training were ‘a lack of frequent opportunities’, ‘case mix’, ‘no suitable trainers’ and ‘insufficient access to formal training’.

Conclusions

This survey has highlighted key issues in RA training in this cohort. There is a reassuring improvement in confidence as trainees progress in training, with trainees undertaking advanced training getting more experience and more confidence to practice independently. However, achieving this for all trainees will require focus from trainers within the region including providing more access to training, courses and increasing the frequency of clinical opportunities.