Key result
Confidence in managing cardiac parturients independently predicts overall obstetric anesthesia confidence.
Why the study?
Taiwan's declining birthrate has reduced obstetric case volume, potentially threatening obstetric anesthesia training and necessitating evaluation of training needs.
Cross-Sectional (n=145)
Yes
Effect estimate: β = 0.61 (95% CI 0.217-0.997)
p-value: p=0.002
Obstetric anesthesia competence and confidence are associated with training exposure, but gaps persist in high-risk and emergency domains, highlighting the need for simulation-based training and inter-institutional collaborations.
May support simulation training for cardiac parturients; leaves open causal effects on competence amid declining volumes.
Background Taiwan’s declining birthrate has reduced obstetric case volume and may threaten obstetric anesthesia training. We examined training experiences, self-perceived competencies, and educational needs in Taiwan to inform feasible curricular strategies.Methods We conducted a cross-sectional nationwide anonymous online survey of anesthesiology residents and attending anesthesiologists in Taiwan (October 1–December 31, 2024). The 37-item questionnaire covered demographics, self-assessed competencies and confidence, satisfaction with current training, and future training preferences, with open-ended items on barriers to additional training. Descriptive statistics, independent-samples t tests, one-way ANOVA, Pearson correlations, and linear regression were performed.Results A total of 145 valid responses were analyzed (112 attendings, 33 residents), yielding an overall response rate of 8.3% (attendings 7.8%, residents 10.4%). Self-assessed competence increased with greater clinical seniority and longer obstetric anesthesia training duration. Highest-rated competencies were neuraxial anesthesia for cesarean delivery (mean 7.93) and airway management during general anesthesia in obstetric patients (7.82), whereas confidence was lower for managing cardiac parturients (6.21) and neonatal resuscitation (5.89). Attendings reported higher overall confidence in independently performing obstetric anesthesia than residents (8.00 vs 6.52, p < 0.001). Male respondents were significantly older than female respondents (mean 41.9 vs. 35.4 years, p < 0.001). Correspondingly, male respondents reported higher confidence than female respondents for independent practice (8.05 vs 7.08, p < 0.001) and for managing cardiac parturients (6.63 vs 5.59, p = 0.001). In multivariable regression, confidence in managing cardiac parturients (β = 0.61, 95% CI 0.217–0.997; p = 0.002) and competence in neuraxial anesthesia for cesarean delivery (β = 1.214, 95% CI 0.190–2.238; p = 0.020) independently predicted overall confidence.Conclusions Obstetric anesthesia competence and confidence were associated with training exposure, yet gaps persisted in high-risk and emergency domains and differed by gender. Programs should prioritize simulation-based training for rare critical events and develop inter-institutional collaborations to strengthen competency acquisition amid declining obstetric volumes.
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Hu et al. (2026) conducted a cross-sectional in Anesthesiology residents and attending anesthesiologists (n=145). Obstetric anesthesia training exposure and clinical seniority vs. Lesser training exposure or junior clinical seniority was evaluated on Overall confidence in independently performing obstetric anesthesia (predicted by confidence in managing cardiac parturients) (β = 0.61, 95% CI 0.217-0.997, p=0.002). Confidence in managing cardiac parturients and competence in neuraxial anesthesia for cesarean delivery independently predicted overall confidence in independently performing obstetric anesthesia.
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