136 Which blocks can you do? An assessment of anaesthetic trainee confidence performing common peripheral nerve blocks

Background and Aims Recent opinion has suggested focusing training on a small number of ‘Plan A blocks’ to improve basic regional anaesthesia competence amongst non-regional enthusiasts1. We assessed trainee confidence performing Plan A blocks with indirect supervision. We also sort trainee opinion regarding which techniques should be designated as essential competencies and how our regional anaesthesia training could be improved. Methods We performed an email survey of all anaesthetic trainees within the East Midlands School of Anaesthesia exploring their confidence in performing regional anaesthesia. Results We received 40 trainee responses (7 CT1-CT2, 13 ST3-ST5, 20 ST6-ST7). Trainees confident in performing plan A blocks under indirect supervision were (numbers are expressed as% [positive responses/total responding]): Interscalene 60 [24/40]; axillary 60 [24/40]; [NB1] femoral 87.5 [35/40]; adductor canal 42.5 [17/40]; popliteal 65 [26[NB2]/40]; erector spinae 10 [4/40]; rectus sheath blocks 42.5 [17/40]. Trainees responding that individual blocks should be included as core competencies: Interscalene 87.2 [34/40]; axillary 84.6 [33/40]; femoral 87.5 [35/40]; adductor canal 56.4 [22/40]; popliteal 76.9 [30/40]; erector spinae 10 [4/40]; rectus sheath blocks 67.5 [27/40].80% of our trainees expressed a desire for regular local teaching and 50% wanted teaching to focus on a reduced number of essential blocks. Conclusions The majority of our trainees felt confident performing most plan A nerve blocks with indirect supervision. Opinion regarding which blocks should be essential competencies mirrored these results. We have commenced regular small group teaching sessions focusing on Plan A blocks.