背景:进入神经轴间隙,包括腰椎穿刺和神经轴麻醉,是临床实践中的日常程序。传统上,这些程序依赖于手动触诊技术,但是当患者证明具有挑战性时,超声波是一个有用的工具。目前,缺乏基于证据的技术技能获取指南,有和没有超声波,同样,能力评估方法在全球范围内各不相同。因此,我们的目标是评估当前关于神经轴通路±$\\pm$$超声学习和评估的证据,未来的教育建议。
方法:本范围审查将根据系统和荟萃分析(PRISMA)声明的首选报告项目进行。与PRISMA扩展一起进行范围审查。系统的搜索策略将基于PICO方法,专注于医生,医学生,或者护士受到教育,培训,或在手术中轴入路±$$\\pm$$超声评估。没有义务比较,但应该使用Kirkpatrick四级培训评估来评估结果。搜索将在Cochrane图书馆进行,Embase,Medline,Scopus,PubMed,和CINAHL。独立地,两位作者将筛选研究,冲突将由第三作者解决。将使用描述性方法提取和分析相关的预定数据。将使用医学教育研究研究质量工具评估研究质量。
结论:本范围审查将通过提供收集的证据来提供有关实现神经轴入路技术技能教育和培训的不同方法的概述,以及如何测试技能,这可以指导技能开发和评估的研究和未来的建议。
BACKGROUND: Access to the neuraxial space, including lumbar punctures and neuraxial anaesthesia, is an everyday procedure in clinical practice. Traditionally these procedures rely on manual palpation technique, but ultrasound is a useful tool when patients prove challenging. Presently, there is a lack of evidence-based guidelines for technical skills acquisition, both with and without ultrasound, and likewise, competency assessment approaches vary globally. Accordingly, we aim to assess the current evidence regarding learning and assessment in neuraxial access ± $$ \\pm $$ ultrasound, for future educational recommendations.
METHODS: This scoping review will be conducted in accordance with the Preferred Reporting Items for Systematic and Meta-Analysis (PRISMA) statement, together with the PRISMA Extension for Scoping Reviews. A systematic search strategy will be based on a PICO approach, focusing on physicians, medical students, or nurses being exposed to education, training, or assessment in procedural neuraxial access ± $$ \\pm $$ ultrasound. No comparators are obligated, but outcomes should be assessable using the Kirkpatrick four levels of training evaluation. The search will be performed in Cochrane Library, Embase, Medline, Scopus, PubMed, and CINAHL. Independently, two authors will screen the studies and conflicts will be resolved by a third author. Relevant predefined data will be extracted and analysed using a descriptive approach. The quality of the studies will be assessed using the Medical Education Research Study Quality Instrument.
CONCLUSIONS: This scoping review will contribute by presenting gathered evidence of an overview of the different approaches to achieving education and training of technical skills in neuraxial access, and how skills are tested, which could guide research and future recommendations for skills development and assessment.