Critical thinking among anesthesiology residents – “Epidural test dose”-Based experiment

Introduction: During the postgraduate course, one is expected to think critically, analyze the clinical situation, and react appropriately. The practice of test dose administration among anesthesiologists is variable. As an initial experiment, we decided to study the common practice of test dose administration through epidural catheters in anesthesia postgraduate students. Methods: After approval from the institutional ethics review board, during a national academic meet for postgraduates, the delegates were asked to fill a 12-item-based survey questionnaire, in English, pertaining to the practice of test dose administration and its interpretation. Results: Eighty-five percent of delegates replied that they were practicing administration of test dose after epidural catheter insertion. Seven percent got the purpose of test dose right. Around 10% of delegates could give correct answer for composition of test dose and 9% of delegates could rightly differentiate between interpretation of test dose for thoracic and lumbar-placed epidural catheters. Discussion and Conclusion: Young anesthesiologists do have a lacuna in knowledge about the basics of administration of test dose, the key components, and the effect it can produce. The students also lack the ability to analyze the effect that the test dose would produce when administered at different segmental levels. Future research critically evaluating our current education process is probably the need of the hour.