Emergency Physician Ultrasound-guided Nerve Block Training Simulation Assessment: a Prospective Cohort Study

BackgroundStandardized training and competency testing is needed for appropriate point-of-care ultrasound (POCUS) clinical use. Our study objective assesses a low-fidelity simulation pig model workshop and tests the knowledge and technical skills of emergency medicine (EM) clinicians when performing simulated ultrasound-guided serratus anterior nerve block (UG-SANB). MethodsEM residents, attendings, and advanced practice providers (APP) participated in a prospective cohort study, completing a one-time simulation-based UG-NB training session at a single academic medical center between November 2024 to February 2025. Training model acceptability, appropriateness, and feasibility was assessed using the validated AIM-IAM-FIM tool (pre/post-surveys). Effectiveness outcomes were participant knowledge score, technical skill score, and self-rated confidence in performing NBs pre-, post-, and 3-months post-intervention. Clinical ED-performed ultrasound-guided nerve blocks were reported pre-/post-intervention. Scores were summarized using mean (S.D.) and total question percent correct. Paired individual assessments were compared pre/post-intervention using paired t-tests and group assessments using t-tests for normal data distribution. Results63/104 ED providers (60.6%) responded to surveys pre-intervention and 57 post-intervention (54.8%). 63 providers (16 EM attendings, 33 residents, and 14 APPs) underwent SANB training and testing. Participant survey responses reported the training model was acceptable, appropriate, and feasible (at least 54/57 agreed or strongly agreed for all three). Mean knowledge scores were 85% (SD 14.8%) post- and 70% (SD 18.2%) 3-months post-workshop. Mean technical skills exam scores were 98% (SD 4.5%) post- and 95% (5.8%) 3-months post-intervention. Perceived confidence in teaching clinical NBs increased pre-/post-intervention (from 11.3% to 58.2%) and for SANB (3.2% to 70.2%). Clinically performed NBs at pre and post were 21 and 15 respectively. ConclusionEmergency clinicians knowledge, technical skills, and confidence scores increased after an UG-NB training intervention. This standardized, reproducible simulation model could improve clinical skills and patient care outcomes but needs additional steps to increase clinical UG-NB performance.