P.89 A new teaching programme for novices in obstetric anaesthesia: Basic Obstetric Anaesthetic Skills Training (BOAST)

Abstract

Introduction: The 2020 Royal College of Anaesthetists’ report Guidelines for the Provision of Anaesthesia Services for an Obstetric Population states that “working on delivery units can be incredibly rewarding for obstetric anaesthetists… but it can also be highly challenging”.1 Anecdotally, it is recognised that many juniors feel unprepared when first rotating into obstetric anaesthesia. Local trainees highlighted that, whilst induction to their obstetric rotation was useful, they felt unprepared for the practical aspects of the job;the different anaesthetic techniques and also the change in working environment with an unfamiliar multidisciplinary team dynamic. Furthermore, the unfamiliar obstetric terms meant that many felt they had little confidence and struggled to ’catch up’ to where they felt they needed to be to work comfortably. We decided to arrange a one-day teaching programme for trainees who were about to rotate into obstetrics to address these shortcomings and demystify some aspects of labour ward. Methods: A survey was sent to core trainees across South Wales to identify interest in the course and main areas of concern. These areas were: anaesthetic techniques, labour ward ‘tips and tricks’, communication and team-working, basic obstetric physiology and jargon-busting, basics of cardiotocography, management of obstetric emergencies, and topics relevant to the Primary FRCA. Colleagues from anaesthetics, obstetrics and midwifery kindly agreed to provide this teaching via lectures, interactive small-group skills stations and faculty-led demonstrations. Delegate numbers were restricted to 12 due to COVID-19 social distancing regulations and a small fee was charged to cover personal protective equipment costs, lunch and refreshments. Results: In the pre-course questionnaire, 91% of respondents felt they would benefit from a course, 63% felt between ‘ambivalent’ and ‘very uncomfortable’ with their understanding for how labour ward works, 54% were ‘uncomfortable’ with their technical skills relating to obstetric anaesthesia, 77% were not comfortable with managing obstetric emergencies and 64% were not comfortable with obstetric terminology and jargon. Post-course feedback was as follows: 86% of candidates reported feeling ‘somewhat’ or ‘very comfortable’ with how labour ward worked. 86% felt confident in their obstetric technical skills, 72% felt confident managing obstetric emergencies and 100% of respondents were comfortable with obstetric terminology. Discussion: We are not aware of any teaching programme in our region for trainees rotating into obstetrics for the first time. Our aim was to address the anxieties identified by junior trainees by providing additional teaching to enhance induction into working on labour ward. The BOAST course was attended by trainees from several hospitals across South Wales. Feedback was extremely positive and as a result we plan to run the course twice a year to facilitate up-to-date teaching for those rotating into obstetric departments.