Introduction of “EDRA Approved” criteria for workshops

European Diploma in Regional Anaesthesia (EDRA) has continued to gain popularity among anaesthesiologists across the world since its introduction in 2006. There are some important prerequisites the candidates need to submit as part of their application to take the exam. Providing the evidence of attendance for at least 3 RA workshops is essential in order to ensure that the candidates are appropriately prepared for the high standards required for success in the exam.

From the 3 workshops, at least one must be an official ESRA workshop (WS), at least one must be cadaveric, and one can be ultrasound scanning WS. THE required ESRA workshop does not have to be a cadaveric WS and similarly the cadaveric WS does not need to be an ESRA workshop.

ESRA obviously knows their faculty for their own workshops, but it has become more and more of a concern that the quality of workshops available to EDRA candidates may be of variable quality. Some workshops may also have a very high number of candidates per 1 workshop station, which limits the scanning and learning opportunities for candidates. There would also be a huge discrepancy in the number of hours spent learning at these workshops, for example some candidates may spend 28 hours in workshops and others only 10 hours, but both would still fulfil the current EDRA exam criteria.

Therefore, from October 2021 ESRA has published updated and much more detailed criteria for workshops required for EDRA exam. There is still a need to attend at least one ESRA official WS, but the total number of workshops has changed to a points system. Please be aware, that candidates need to submit the evidence of the collected points from all required workshops only for EDRA Part 2 exam. That means, the candidate can apply for EDRA Part 1 (written) exam without completing all necessary workshop points.

In order to apply for EDRA Part 2 exam, candidate must present at least 20 points from the EDRA approved workshops, whilst providing the evidence for:

• At least 6 points hands-on cadaveric points (HO-CP)
• At least 10 points hands-on ultrasound points (HO-UP)

It needs to be highlighted, that all 20 points cannot be obtained in one workshop.

By offering the general criteria for organisers of regional anaesthesia workshops in European countries, ESRA wishes to expand the pool of approved high-quality workshops in more countries and allow the candidates to be able to choose which workshop they would like to attend according to their needs in terms of geographical proximity, language or workshop points offered / required for the EDRA exam. An approved list of workshops according to the countries will soon be created as well as list of workshop categories (cadaveric, ultrasound, official ESRA) giving full flexibility to the candidates to make the right choice.

The EDRA board realises that new criteria may seem daunting and difficult to implement for candidates and course organisers. Therefore, there will be an initial grace period where workshops attended before June 2022 will still be valid for EDRA exam criteria. The EDRA board will apply some flexibility until the new criteria has been fully established, with the expectation that workshops from July 2022 apply for EDRA points and “ EDRA Approved” status.

To make it easier for our readers and workshop directors who would like to apply for “EDRA Approved” status for their workshop the following workshop points are highlighted in different colour:

Hands – on cadaveric points (HO-CP)                       Other cadaveric points (CP)
Hands – on ultrasound points (HO-UP)                    Other ultrasound points (UP)

Cadaveric points – CP

• 1 point awarded for every 1 hour of direct hands-on practice with cadavers (dissected specimens, soft embalmed or fresh cadavers).
  Example: 6 hours of cadaveric hands-on practice = 6 HO-CP
• 0.5 point awarded for every hour of anatomy related lecture
  Example: 4 hours of cadaveric lectures = 2 CP
• Lectures which are not related to applied anatomy will not be counted

Ultrasound points – UP

• 1 point awarded for every 1 hour of direct hands-on ultrasound scanning of live model / needling on phantom
  Example: 6 hours of ultrasound scanning = 6 HO-UP
• 0.5 points awarded for every 1 hour of sono-anatomy related lecture / demo
  Example: 4 hours of lectures/demo = 2 UP
• Lectures / demos which are not related to ultrasound and sono-anatomy will not be counted

Rounding the total time for points

• Full hours will be counted without change
• 0-29 min will be rounded to previous hour
• 30-59 min will be rounded to next hour
  Example 1: 5 hours and 20 minutes = 5 hours
  Example 2: 5 hours and 45 minutes = 6 hours

Final point count

HO-CP             Hands – on cadaveric points are displayed on workshop certificate separately
HO-UP             Hands – on ultrasound points are displayed on workshop certificate separately
OP                      Other points are calculated by adding CP (cadaveric points) and UP (ultrasound points) together. Other points represent all cadaveric or ultrasound “non hands – on” points awarded for the workshop

Certain minimum standards for “EDRA Approved” workshops are necessary to maintain high quality teaching and fulfil the learning needs for our candidates

• Cadaveric and/or ultrasound points must be successfully submitted by WS director and approved by ESRA
• At least 50% of the workshop faculty members must be ESRA members (or other EDRA approved partner organisation – e.g. ASRA, AOSRA, LASRA)
• Workshop director must be EDRA diplomate and/or have academic background and/or substantive teaching experience in the field of regional anaesthesia and acute pain management
• Maximum number of participants per group is 8 for ultrasound and for cadaveric workshops to allow appropriate hands-on experience
• EDRA Board reserves the right to send EDRA Board member, EDRA examiner or other EDRA Board approved person to personally inspect the course at the expenses of workshop organiser.

Recommendations for EDRA Approved workshop (WS) application process:

• Submit the programme of the WS to the national organisation for CME/CPD* approval
• After granted CME/CPD, submit both the programme and CME/CPD approval to ESRA for assessment by email and specify in the table below the hours of anatomy/ Sono-anatomy lectures as well as cadaveric / ultrasound hands-on practice
• WS director should allow 2 calendar months for EDRA Board/COR response of their WS assessment
• EDRA Approved status is issued to organiser of the workshop for the duration of up to 3 calendar years (including the year of registration). After this period, WS director must reapply for EDRA Approved status again.
• Organisers must submit candidates feedback within 30 days after the workshop in order to keep the EDRA Approved status for next calendar year. ESRA feedback templates are downloadable for Cadaveric and Ultrasound Workshops.
• Workshop must comply with EDRA Approved minimum standards
• When the programme of the workshop changes dramatically, which will result in change of WS points, organiser must submit a new application.
• WS director can use “EDRA Approved” logo on all advertising materials related to WS, certificate as well as on the screen during the WS.

*CME – continuous medical education
*CPD – continuous professional development