Introduction. Properly performing a subarachnoid block (SAB) is a competency expected of anesthesiology residents. We aimed\nto determine if adding simulation-based deliberate practice to a base curriculum improved performance of a SAB. Methods. 21\nanesthesia residentswere enrolled.After baseline assessment of SAB on a task-trainer, all residents participated in a base curriculum.\nResidents were then randomized so that half received additional deliberate practice including repetition and expert-guided, realtime\nfeedback. All residents were then retested for technique. SABs on all residents� next three patients were evaluated in the\noperating room (OR). Results. Before completing the base curriculum, the control group completed 81% of a 16-item performance\nchecklist on the task-trainer and this increased to 91% after finishing the base curriculum (P < 0.02). The intervention group also\nincreased the percentage of checklist tasks properly completed from 73% to 98%, which was a greater increase than observed\nin the control group (P < 0.03). The OR time required to perform SAB was not different between groups. Conclusions. The\nbase curriculum significantly improved resident SAB performance. Deliberate practice training added a significant, independent,\nincremental benefit. The clinical impact of the deliberate practice intervention in the OR on patient care is unclear
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