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Is it time to build in blocks?

Dr Cathryn Malins and Dr Madeleine Storey explain why formalising training time in regional anaesthesia will facilitate trainees' learning at all stages.

Over the last five years, regional anaesthesia in clinical practice has been on a trajectory – growing in importance and prominence in the anaesthesia community. Efforts by the 8th National Audit Project and the BJA have helped further increase the publicity of regional anaesthesia. While we can all see the merit in this growth, is this the time for a more formalised place in the training programme for regional anaesthesia?

As with any practical procedure, there are many ways to learn, but it is practically impossible to become competent or excellent at regional anaesthesia without regular hands-on patient experience. Recent UK-wide surveys revealed a large proportion of Stage 3 trainees unable to perform all Plan A blocks independently, and found that only a small proportion of consultants and specialists felt confident teaching all these blocks to trainees. It has also been seen that the higher the number of blocks trainees perform, the more confident they feel. Currently, ‘getting numbers’ and achieving the required competence, feels challenging.

We acknowledge that there is an inevitable period of adjustment following curriculum transition, but many of our trainee colleagues still feel their current skills in this area are inadequate for their level of training. To prevent this becoming a perpetual challenge this issue must be proactively addressed across all stages of training.