Simulation-based training for fascial plane blocks: A scoping review mapped to the Kirkpatrick evaluation framework.

Abstract

Fascial plane blocks are integral components of multimodal analgesia, and ultrasound guidance improves the precision and safety. Simulation-based training is a promising approach to improvise procedural performance. However, evidence suggesting translation to patient-level outcomes is limited. This scoping review aimed to explore the available evidence on the impact of simulation based training for fascial plane blocks, mapping outcomes to the Kirkpatrick (KP) evaluation framework. A systematic search was conducted per PRISMA-ScR guidelines from standard databases. Eligible studies involved physicians, residents, or certified registered nurses from anaesthesiology and emergency medicine undergoing simulation-based fascial plane block training. Data were extracted on study characteristics, training modalities and duration, block type, assessment tools, feedback from participants, and outcomes. Fourteen pre-/post-interventional studies involving 458 participants were included. Most interventions combined didactic sessions, video demonstrations, and simulation-based training using commercial or custom models. Transversus abdominis plane, serratus anterior plane, erector spinae plane, and fascia iliaca compartment blocks were studied. Outcomes assessment predominately targeted lower KP levels, focussing on learners' confidence, knowledge, or improved performance in the simulated or clinical environment, immediate post-training. Long-term follow-up was limited, with most evaluations conducted within 3 months of training. Patient-centred outcomes such as complication, infection rate, or patient satisfaction were rarely assessed. Future research should employ validated assessment tools, isolate the impact of simulation from other modalities, and evaluate higher KP levels, including patient outcomes and system-level changes, to establish its true clinical value.