Z. Kulcsar

ABSTRACT 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. 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. 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. 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.

Materials and Methods: This study comprised two phases: 1. The design of Tactile Landscapes 2. The testing phase. The first (design) phase was informed by: i. analysis of video material acquired in the operating room, ii. previously identified determinants of teaching and learning efficacy of spinal anaesthesia, and iii. input on tactile sensation relevant to the procedure from practicing anaesthetists. The second phase involved 24 experts (anaesthetic doctors) and 12 non-experts (medical students) who were invited to ...