Feedback Pediatric Urology Regional Block Guided by Ultrasound

Resident "self-reflects" performance shown

Attending directs Resident "self-reflections"

Resident reviews Attending comments

Trainee: % Case I did*

Attending: % Case Trainee did*

Trainee Skill level shown*

Attending: Trainee Skill level shown*

Trainee: Global Block Skills

	well done, no improvement needed	some improvement needed	much improvement needed	unacceptable performance intense improvement needed	N/A
knows block steps
knows names of ultrasound landmarks
works with assistant well
Professional: respectful & effectively communicates

Attending: Global Block Skills Trainee showed

	well done, no improvement needed	some improvement needed	much improvement needed	unacceptable performance intense improvement needed	N/A
knows block steps
knows names of ultrasound landmarks
works with assistant well
Professional:respectful & effectively communicates

Trainee: Basic Inguinal Block Skills

	well done, no improvement needed	some improvement needed	much improvement needed	unacceptable performance intense improvement needed	N/A
Agree on block with staff
Consent/sitemark
Block materials
Hand position of block needle
Advance block needle
Identify nerves
Instill test dose then remainder of local anesthetic
Clean up

Trainee: Basic Caudal Block Skills

	well done, no improvement needed	some improvement needed	much improvement needed	unacceptable performance intense improvement needed	N/A
Confer with surgeon
Prepare materials
Evaluate patient/obtain consent for block
Identify landmarks
Anesthetize patient
Prep/Drape
Place needle
Test and instill
Reposition

Attending: Basic Inguinal Block Skills Trainee Showed

	well done, no improvement needed	some improvement needed	much improvement needed	unacceptable performance intense improvement needed	N/A
Agree on block with staff
Consent/sitemark
Block materials
Hand position of block needle
Advance block needle
Identify nerves
Instill test dose then remainder of local anesthetic
Clean up

Attending: Basic Caudal Block Skills Trainee Showed

	well done, no improvement needed	some improvement needed	much improvement needed	unacceptable performance intense improvement needed	N/A
Confer with surgeon
Prepare materials
Evaluate patient/obtain consent for block
Identify landmarks
Anesthetize patient
Prep/Drape
Place needle
Test and instill
Reposition

Pediatric Urology Regional Block Guided by Ultrasound: Feedback to Trainees