Effect of feedback content on novices' learning ultrasound guided interventional procedures

Feedback, of various forms, is effective at improving performance of medical procedures in simulated and clinical settings. Our objectives were to compare the effects of two forms of feedback on i) novice learning of in-plane technique for ultrasound-guided interventional procedures and ii) to evaluate novice retention of skill 24 hours after a standard learning session.

Performance data were collected from 30 novices. All participants received training in the form of a standard training video. Participants were randomly allocated to one of three groups: Group C (Control) received no feedback; Group KR (Knowledge of Result) received feedback at the end of each series of tasks in the form of predefined performance intervals; and Group KP (Knowledge of Procedure) received feedback in the form of augmented error feedback. Each participant completed the series of tasks five times, using a standardized phantom model. Participants attempted to perform the same tasks 24 hours later using the same phantom. This performance was videotaped and assessed by two blinded assessors for predefined time and errors.

All groups demonstrated significant learning effect in terms of imaging, needling and performance time. Error reduction was significant over time intervals measured and also in-between groups with significant difference between Control : KP (P<0.001) and KR: KP (P=0.001) but not between Control and KR groups. Marked and similar levels of skill attrition were identified in all three groups 24 hours after the learning phase

When feedback was based on KP, novices acquired pre-defined skills more quickly and made fewer errors during the learning phase (compared with controls). When feedback content was based on KR novices acquired pre-defined skills more quickly but made similar numbers of errors during the learning phase (compared with controls). In conclusion, these findings should inform development of training and assessment programs for peripheral nerve blockade.