Comparison of spinal mannequin-based simulation teaching with the conventional didactic method of teaching subarachnoid block in novices: A randomized controlled trial

Abstract Background and Aims: Neuraxial anesthesia is a core anesthetic skill, but traditional patient-based teaching carries ethical and safety concerns. Simulation-based training offers a structured, risk-free environment for novices to gain competence before performing procedures on patients. This study aimed to compare the subarachnoid block simulation performance of novice postgraduate students of anesthesiology after spinal mannequin-based and conventional didactic methods of teaching. Material and Methods: This study included 50 novice anesthesia residents who were randomly assigned to Group A and Group B. Group A received mannequin-based instruction, while Group B received didactic instruction. They were then assessed on patients for the number of successful first needle passes or redirections, time taken to successfully perform neuraxial anesthesia/analgesia, total number of attempts, complications, number of needle bone contacts, and ease of landmark palpation of space. Results: Twenty novices in group A (n = 25) successfully performed spinal anesthesia on the first attempt as compared to 7 (n = 25) in group B ( P = 0.001). Patients in group A had a lower number of needle bone contacts as compared to group B (6 vs 19, P = 0.002). Also, the procedural time was much less in group A (127 ± 66.4 seconds) as compared to group B (173 ± 68.9) ( P = 0.01). Conclusions: Novices trained on mannequins had higher successful first pass attempts, fewer procedural errors, and shorter procedural times. Mannequin-based stimulation teaching should be considered for training all novices in subarachnoid block.