Lindsay Hahn
University of Pittsburgh Medical Center
Background: Peripheral nerve blockade (PNB) is an important component of multimodal analgesia and is increasingly important in today’s healthcare landscape. The Accreditation Council for Graduate Medical Education (ACGME) minimum requirement for PNB exposure in anesthesiology residency is that a resident is to have performed forty peripheral nerve blocks by the end of their clinical training. Aside from the total number of PNB performed and months spent on regional rotations, little is known about the specific clinical experiences in PNB residents have at the University of Pittsburgh Medical Center Anesthesiology (UPMC) residency program.
Aims: To explore the clinical experience with PNB of residents at UPMC Anesthesiology residency program and compare the regional experience against the logged experience of other subspecialties.
Methods: Data were collected using retrospective review of ACGME case logs and electronic medical records to obtain both historical and cross-sectional information about peripheral nerve blockade performance by residents. Logged ACGME data of other anesthesiology subspecialties will be collected for comparison.
Results: With an average of 315 PNB logged by graduating residents, the clinical experience with regional anesthesiology far surpasses ACGME requirements. The PNB exposure is not equal between hospital sites, with one hospital site providing less breadth of blocks than the other sites and one hospital site performing much fewer blocks per resident per day than the others, although each site offers unique benefits to residents. The logged experience of residents surpasses the minimum requirements in PNB significantly more than residents surpass minimum requirements of other anesthesiology subspecialties including thoracic, cardiac, neurosurgical, vascular, and pediatric anesthesiology.
Conclusions: The resident experience at UPMC with PNB surpasses minimum expectations for ACGME guidelines. Residents performing PNB at more than one hospital site throughout their training ensures their overall experiences are similar. Given increased focus on multimodal analgesia and overall trends in surgical procedures, increasing the total PNB requirement and delineating minimums for specific PNB would better prepare residents for their future careers.
