Curriculum development for an advanced regional anesthesia education program: one institution's experience from apprenticeship to comprehensive teaching.

Results of recent attitude survey studies suggest that most practicing physicians are inadequately treating postoperative pain. Residents in anesthesia are confident in performing lumbar epidural and spinal anesthesia, but many are not confident in performing the blocks with which they have the least exposure. Changes need to be made in the training processes to a comprehensive model that prepares residents to perform a wider array of blocks in postgraduate practice. Here, we describe one institution's approach to creating a standardized, advanced regional anesthesia curriculum for residents that follows the six core competencies of the ACGME. Residents received training in anatomy dissection, ultrasound-guided regional anesthesia, traditional nerve stimulation techniques, problem-based learning and simulation sessions, oral board presentation sessions, and journal club sessions. Residents kept a detailed log for their use of peripheral nerve block procedures. We have now redesigned and implemented an advanced regional anesthesia program within our institution to provide residents with experience in regional anesthesia at a competent level. Resident's knowledge in regional anesthesia did improve after the first year of implementation as reflected in improvements between the pre- and post-tests. As the advanced regional anesthesia education program continues to improve, we hope to demonstrate levels of validity, reliability, and usability by other programs.