Evaluating perceived obstetric anesthesia training needs in residency education: a Taiwanese national survey

Taiwan's declining birthrate has reduced obstetric case volume and may threaten obstetric anesthesia training. We examined training experiences, self-perceived competencies, and educational needs in Taiwan to inform feasible curricular strategies.

We conducted a cross-sectional nationwide anonymous online survey of anesthesiology residents and attending anesthesiologists in Taiwan (October 1-December 31, 2024). The 37-item questionnaire covered demographics, self-assessed competencies and confidence, satisfaction with current training, and future training preferences, with open-ended items on barriers to additional training. Descriptive statistics, independent-samples t tests, one-way ANOVA, Pearson correlations, and linear regression were performed.

A total of 145 valid responses were analyzed (112 attendings, 33 residents), yielding an overall response rate of 8.3% (attendings 7.8%, residents 10.4%). Self-assessed competence increased with greater clinical seniority and longer obstetric anesthesia training duration. Highest-rated competencies were neuraxial anesthesia for cesarean delivery (mean 7.93) and airway management during general anesthesia in obstetric patients (7.82), whereas confidence was lower for managing cardiac parturients (6.21) and neonatal resuscitation (5.89). Attendings reported higher overall confidence in independently performing obstetric anesthesia than residents (8.00 vs 6.52, p < 0.001). Male respondents were significantly older than female respondents (mean 41.9 vs. 35.4 years, p < 0.001). Correspondingly, male respondents reported higher confidence than female respondents for independent practice (8.05 vs 7.08, p < 0.001) and for managing cardiac parturients (6.63 vs 5.59, p = 0.001). In multivariable regression, confidence in managing cardiac parturients (β = 0.61, 95% CI 0.217-0.997; p = 0.002) and competence in neuraxial anesthesia for cesarean delivery (β = 1.214, 95% CI 0.190-2.238; p = 0.020) independently predicted overall confidence.

Obstetric anesthesia competence and confidence were associated with training exposure, yet gaps persisted in high-risk and emergency domains and differed by gender. Programs should prioritize simulation-based training for rare critical events and develop inter-institutional collaborations to strengthen competency acquisition amid declining obstetric volumes.