Bridging The Skills Gap: A Call For Greater Exposure To Ultrasound-guided Peripheral Nerve Blocks Among Anaesthesia Trainees In Kenya And Zambia

Bridging The Skills Gap: A Call For Greater Exposure To Ultrasound-guided Peripheral Nerve Blocks Among Anaesthesia Trainees In Kenya And Zambia

Daniel Owambo , Sonia Lalla, Arthur Polela
Aga Khan University Hospital, Nairobi, Kenya; University Teaching Hospital, Lusaka, Zambia

Background: Anaesthesiology is continually evolving, with growing complexity and higher skill demands. Competency-based training programmes aim to develop these essential competencies. Across Africa, anaesthesia education remains heterogeneous, prompting the establishment of the College of Anaesthesiologists of East, Central and Southern Africa (CANECSA) to standardise postgraduate training. The quality of regional anaesthesia rotations varies considerably between institutions, influenced by case load and available resources. This project evaluated the proficiency of trainee anaesthesiologists in Kenya and Zambia in performing ultrasound-guided peripheral nerve blocks.

Methods: An online survey was administered to anaesthesiology trainees who had completed at least one year of training by May 2023. Participants included residents from:
• Kenya – Aga Khan University Hospital, Nairobi, and the University of Nairobi
• Zambia – University Teaching Hospital, Lusaka

The survey assessed trainees’ confidence in performing ultrasound-guided regional anaesthesia and documented the number and types of blocks performed at various stages of training.

Results: A total of 44 residents participated (31 from Kenya and 13 from Zambia). The blocks most infrequently and least confidently performed were the adductor canal, fascia iliaca, and rectus sheath blocks. Junior residents reported the lowest confidence with brachial plexus blocks. Apart from the transversus abdominis plane (TAP) block, over half of trainees had performed fewer than ten of each block type. The main barriers identified were limited exposure (54%) and inadequate resources (45%).

Conclusions:Training programmes must rise to the challenge—expanding hands-on, ultrasound-guided regional anaesthesia exposure through collaborative blended learning hands-on workshops, simulation training, and active conference engagement.

Keywords: Nerve Blocks, Ultrasound, Trainees