Evidence map›Paper›PMID 40628584›Full record

ArticleBritish journal of anaesthesia2025

Training and assessment of skills in neuraxial space access: a scoping review of educational approaches to lumbar puncture, epidural anaesthesia, and spinal anaesthesia.

Martine Siw Nielsen, Frederik Veitland Ilkjær, Anders Morten Grejs, Anders Bo Nielsen, Lars Konge, Anne Craveiro Brøchner

Abstract readScoping Review
PubMed Full text at PMC Publisher
In one paragraph

Article in British journal of anaesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Trial
  2. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Martine Siw NielsenDepartment of Anaesthesiology and Intensive Care, Lillebaelt University Hospital, Kolding, Denmark; Research Unit of Medical Education, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Regional Health Research, Region of Southern Denmark, Odense, Denmark. Electronic address: Martine.Siw.Nielsen@rsyd.dk.
Frederik Veitland IlkjærDepartment of Anaesthesiology and Intensive Care, Lillebaelt University Hospital, Kolding, Denmark.
Anders Morten GrejsDepartment of Intensive Care Medicine, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Anders Bo NielsenResearch Unit of Medical Education, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Anaesthesiology and Intensive Care, Odense University Hospital, Svendborg, Denmark.
Lars KongeResearch Unit of Medical Education, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Copenhagen Academy for Medical Education and Simulation, Center for HR & Education, The Capital Region of Denmark, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Anne Craveiro BrøchnerDepartment of Anaesthesiology and Intensive Care, Lillebaelt University Hospital, Kolding, Denmark; Department of Regional Health Research, Region of Southern Denmark, Odense, Denmark.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNeuraxial space access, including lumbar puncture, spinal anaesthesia, and epidural anaesthesia, is important in clinical practise for diagnostics and anaesthesia. Despite frequent use, standardised educational recommendations for training and assessing proficiency in these procedures are not well-integrated. The following research question was formulated: what is known from published literature to guide future educational recommendations for training and skills assessment of neuraxial space access with and without the use of ultrasound?

methodsOn May 7, 2024, searches were performed in the Cochrane Library, MEDLINE (Ovid), Scopus, PubMed, CINAHL (EBSCO), and EMBASE (Ovid). Studies were eligible if they involved physicians, medical students, or nurses and focused on training or assessment of neuraxial space access skills. No comparator was required, and all study designs were included if outcomes could be assessed using Kirkpatrick framework. There were no restrictions on language or publication date. Methodological quality was assessed using the Medical Education Research Study Quality Instrument (MERSQI).

resultsThe review included 99 studies, and overall, 28 (28%) of the included studies were of low quality with a MERSQI score <9, whereas 22 (22%) were of high quality with a MERSQI score of ≥14. The designs were primarily cohort studies (68%) and RCTs (24%). Specialities represented were mainly anaesthesia (22%) and paediatrics (17%), but many were not reported (30%). Training modalities varied, predominantly using low-fidelity manikins (55%). Simulation-based methods enhanced procedural confidence and technical skills.

conclusionsStudies on education in neuraxial space access show substantial variation in educational approaches and assessment. Consistent findings indicate that simulation-based training enhances outcomes across multiple Kirkpatrick levels, although the studies generally have low methodological quality. Further high-quality research is needed, especially linking training and assessment to patient outcomes.

Indexed as

Anesthesia, EpiduralAnesthesia, SpinalAnesthesiologyClinical CompetenceSpinal PunctureEducational MeasurementHumansassessmenteducationepidural anaesthesialumbar punctureneuraxial accessspinal anaesthesiatraining

Identifiers

PMID40628584
PMCPMC12674033

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.