Teaching the Epidural Technique

Essentially, we teach as we were taught, when we first learned by watching and then directly on the patient, with the help of a tutor. Even today, the typical teaching of epidural catheter placement in obstetric anesthesia (as well as in other surgical and pain therapy settings) consists of a mix of theoretical didactic training and practical experience, in which the student and teacher together face the task in a clinical setting, using the patient as a learning model. This teaching method is not usually standardized, is hardly formalized and institutionalized, and is highly variable among different university institutes. Teaching and learning in anesthesiology is a challenging and complex task because most of the teaching and learning takes place in a clinical setting, where patient safety and comfort must be balanced with the responsibility of training the resident. Teaching and learning epidural analgesia for labor can be particularly challenging because the patient may be experiencing severe pain and therefore may not be willing to be involved in the educational encounter. Moreover, the clinical context of a delivery room where relatives are present may not be a comfortable environment for teaching and learning. Epidural analgesia for labor can therefore be difficult to teach and learn in a clinical context and represents a challenge for both the teacher and the learner. In this chapter, the general principles of teaching and learning will be illustrated.