Gaze training to improve performance during ultrasound-guided regional anaesthesia
| ISRCTN | ISRCTN95101668 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN95101668 |
| Sponsor | University of Nottingham |
| Funder | Umm Al-Qura University |
- Submission date
- 24/12/2025
- Registration date
- 30/12/2025
- Last edited
- 30/12/2025
- Recruitment status
- Not yet recruiting
- Overall study status
- Ongoing
- Condition category
- Other
Plain English summary of protocol
Background and study aims
Regional anaesthesia is the performance of spinal, epidural or peripheral nerve blocks to provide post-operative pain relief. Anaesthetists inject local anaesthetic using specialist blunt-tipped needles close to nerves to prevent transmission of pain. Hand-held ultrasound is often used by anaesthetists to direct these needles to the correct position i.e. close to, but not in the nerve itself (so-called ultrasound-guided regional anaesthesia, UGRA). If the needle is not adequately seen using the hand-held ultrasound it may pierce the nerve causing permanent nerve damage and significant patient harm. All anaesthetists should be trained in the safe performance of UGRA according to new postgraduate medical curricula issued by the UK Royal College of Anaesthetists.
Within the time and resource constraints of postgraduate medical training (with lack of access to real-world educational opportunities in clinical training), it would be advantageous to optimise acquisition of practical UGRA skills with a self-directed educational intervention which can be administered away from the bedside. Therefore, our aim is to test whether a single episode of gaze training is associated with improved performance at an ultrasound-guided peripheral nerve block task compared with standard self-directed practice. Based on previous work in the field of laparoscopic skill acquisition we hypothesise that gaze control training will improve the technical performance of an ultrasound-guided needle task.
Who can participate?
Qualified medical doctors enrolled in a Royal College of Anaesthetists Stage 1 training programme (novice group), and a small group of consultant anaesthetists with regular clinical experience in ultrasound-guided regional anaesthesia (expert group). All participants must be aged 18 years or older.
What does the study involve?
Each participant will attend a single study visit lasting approximately two hours at the Queen's Medical Centre - University of Nottingham. Participants will complete informed consent, questionnaires these include measures of anxiety, mood, sleepiness, and visuospatial ability. Perform a simulated ultrasound-guided needle task, and wear eye-tracking glasses while completing the task. Novice participants will then be randomly allocated to either a gaze training group or a self-directed (discovery learning) group. All novice participants will repeat the task after training. Performance will be assessed by trained assessors using standardised scoring tools and eye-tracking measurements.
What are the possible benefits and risks of participating?
Participants may benefit from additional educational experience and insight into their performance, although there may be no direct personal benefit. The risks are minimal and include mild fatigue or temporary discomfort from wearing eye-tracking equipment. The task is performed on a bench model and not on patients, so there is no clinical risk.
Where is the study run from?
The study will be conducted at the Academic Unit of Injury, Recovery & Inflammation Sciences, School of Medicine, University of Nottingham, UK.
When is the study starting and how long is it expected to run for?
January 2026 to December 2026.
Who is funding the study?
This study forms part of a PhD programme funded by Umm Al-Qura University, Saudi Arabia. The sponsor of the study is the University of Nottingham, UK.
Who is the main contact?
Osama Natto, PhD Research Student in Anaesthesia, Academic Unit of Injury, Recovery & Inflammation Sciences, School of Medicine, University of Nottingham, UK, osama.natto1@nottingham.ac.uk
Contact information
Principal investigator
Department of Anaesthesia & Critical Care
Queen’s Medical Centre
Nottingham University Hospitals NHS Trust
Room E/C 1719
C Floor, East Block
Queen’s Medical Centre
Nottingham
NG7 2UH
Nottingham
NG7 2UH
United Kingdom
 ORCID ID |
0000-0002-5314-8522 |
|---|---|
| Phone | +44 7778 178639 |
| David.Hewson@nottingham.ac.uk |
Scientific, Public
Academic Unit of Injury, Recovery & Inflammation Sciences
School of Medicine
University of Nottingham
Room E/C 1722
C Floor, East Block
Queen’s Medical Centre
Nottingham
NG7 2UH
Nottingham
NG7 2UH
United Kingdom
| ORCID ID |
0009-0006-6305-5182 |
|---|---|
| Phone | +447949826880 |
| OSAMA.NATTO1@nottingham.ac.uk |
Study information
| Primary study design | Interventional | |
|---|---|---|
| Allocation | Randomized controlled trial | |
| Masking | Blinded (masking used) | |
| Control | Active | |
| Assignment | Parallel | |
| Purpose | Health services research | |
| Scientific title | The effect of gaze training on task performance, safety, and skill acquisition during ultrasound-guided regional anaesthesia: a randomised controlled trial | |
| Study acronym | GAZE Trial | |
| Study objectives | The primary objective of this study is to evaluate whether a gaze-training educational intervention improves task performance during a simulated ultrasound-guided regional anaesthesia procedure compared with discovery learning. Secondary objectives are to describe differences in eye-tracking metrics and objective performance measures between novice and expert participants, and to explore how gaze behaviour relates to skill acquisition. | |
| Ethics approval(s) |
Approved 21/11/2025, Faculty of Medicine & Health Sciences Research Ethics Committee (Research Ethics Committee, E41, E Floor, (next to School of Life Sciences Reception), Medical School, Queen's Medical Centre, Nottingham University Hospitals, NG7 2UH, Nottingham, NG7 2UH, United Kingdom; louise.sabir@nottingham.ac.uk; fmhs-researchethics@nottingham.ac.uk), ref: FMHS 36-1025 | |
| Health condition(s) or problem(s) studied | Training and performance in ultrasound-guided regional anaesthesia among anaesthesia clinicians. | |
| Intervention | Participants will attend a single study visit. All novice participants will first complete a simulated ultrasound-guided regional anaesthesia (UGRA) needle insertion task on a sciatic nerve model (Task 1). The goal is to accurately place the needle toward the target structure located at 6 o’clock using the in-plane technique. Task performance will be independently evaluated by two assessors using the Global Rating Scale (GRS) and the Composite Error Score (CES). Additionally, eye-tracking data will be recorded concurrently. Novice participants will then be randomised in a 1:1 ratio using opaque, sequentially numbered, sealed envelopes to receive either a gaze-training educational intervention or discovery learning. One assessor will be blinded to group allocation and will not be present during envelope opening or delivery of the educational intervention; this assessor will attend only the task assessments. In the gaze-training group, participants will watch a brief, standardised video demonstrating expert visual behaviour during an ultrasound-guided regional anaesthesia procedure. After that, participants will complete five supervised practice attempts using the eye-tracking glasses, during which participants will have to replicate the expert gaze patterns. The control group will undertake discovery learning, and participants will complete five independent UGRA task attempts without receiving any specific gaze-related instruction or guidance. Following the intervention, novice participants will repeat the UGRA task (Task 2) under identical conditions, with performance again independently assessed by two assessors using GRS and CES. Expert participants will complete the initial UGRA task only and will not be randomised. | |
| Intervention type | Behavioural | |
| Primary outcome measure(s) |
| |
| Key secondary outcome measure(s) |
| |
| Completion date | 31/12/2026 |
Eligibility
| Participant type(s) | |
|---|---|
| Age group | Mixed |
| Lower age limit | 18 Years |
| Upper age limit | 120 Years |
| Sex | All |
| Target sample size at registration | 53 |
| Total final enrolment | 53 |
| Key inclusion criteria | 1. Aged 18 years or older. 2. Qualified medical doctors currently enrolled in a Royal College of Anaesthetists training programme for Stage 1 training. 3. Consultant anaesthetist with regular clinical exposure to Ultrasound-guided regional anaesthesia. |
| Key exclusion criteria | Previous experience of gaze training or eye-tracking software applied to medical interventions. |
| Date of first enrolment | 12/01/2026 |
| Date of final enrolment | 31/03/2026 |
Locations
Countries of recruitment
- United Kingdom
- England
Study participating centre
Derby Road
Nottingham
NG7 2UH
England
Results and Publications
| Individual participant data (IPD) Intention to share | No |
|---|---|
| IPD sharing plan summary | Data sharing statement to be made available at a later date |
| IPD sharing plan |
Editorial Notes
24/12/2025: Study’s existence confirmed by the Faculty of Medicine & Health Sciences Research Ethics Committee, Nottingham University Hospitals, UK.
