Medical training in anaesthesiology: Updated European requirements

Teaching airway teachers: a post-course quantitative and qualitative survey

BACKGROUND

Airway management is a crucial skill for many clinicians. Besides mastering the technical skills of establishing a patent airway, human factors including leadership and team collaboration are essential. Teaching these human factors is often challenging for instructors who lack dedicated training. Therefore, the European Airway Management Society (EAMS) developed the Teach-the-Airway-Teacher (TAT) course.

METHODS

This online post-course survey of TAT-course participants 2013-2021 investigated the impact of the TAT-course and the status of airway management teaching in Europe. Twenty-eight questions e-mailed to participants (using SurveyMonkey) assessed the courses' strengths and possible improvements. It covered participants' and workplace details; after TAT-course considerations; and specifics of local airway teaching. Data were assessed using Excel and R.

RESULTS

Fifty-six percent (119/213) of TAT-participants answered the survey. Most were anaesthetists (84%), working in university level hospitals (76%). Seventy-five percent changed their airway teaching in some way, but 20% changed it entirely. The major identified limitation to airway teaching in their departments was "lack of dedicated resources" (63%), and the most important educational topic was "Teaching non-technical skills" (70%). "Lecturing " was considered less important (37%). Most surveyed anaesthesia departments lack a standardized airway teaching rotation. Twenty-one percent of TAT-participants rated their departmental level of airway teaching overall as inadequate.

CONCLUSIONS

This survey shows that the TAT-course purpose was successfully fulfilled, as most TAT-course participants changed their airway teaching approach and did obtain the EAMS-certificate. The feedback provided will guide future TAT-course improvements to advance and promote a comprehensive approach to teaching airway management.

Integration of simulation-based education in anaesthesiology specialist training: Synthesis of results from an Utstein Meeting

BACKGROUND

Despite its importance in education and patient safety, simulation-based education and training (SBET) is only partially or poorly implemented in many countries, including most European countries. The provision of a roadmap may contribute to the development of SBET for the training of anaesthesiologists.

OBJECTIVE

To develop a global agenda for the integration of simulation into anaesthesiology specialist training; identify the learning domains and objectives that are best achieved through SBET; and to provide examples of simulation modalities and evaluation methods for these learning objectives.

DESIGN

Utstein-style meeting where an expert consensus was reached after a series of short plenary presentations followed by small group workshops, underpinned by Kern's six-step theoretical approach to curriculum development.

SETTING

Utstein-style collaborative meeting.

PARTICIPANTS

Twenty-five participants from 22 countries, including 23 international experts in simulation and two anaesthesia trainees.

RESULTS

We identified the following ten domains of expertise for which SBET should be used to achieve the desired training outcomes: boot camp/initial training, airway management, regional anaesthesia, point of care ultrasound, obstetrics anaesthesia, paediatric anaesthesia, trauma, intensive care, critical events in our specialty, and professionalism and difficult conversations. For each domain, we developed a course template that defines the learning objectives, instructional strategies (including simulation modalities and simulator types), and assessment methods. Aspects related to the practical implementation, barriers and facilitators of this program were also identified and discussed.

CONCLUSIONS

We successfully developed a comprehensive agenda to facilitate the integration of SBET into anaesthesiology specialist training. The combination of the six-step approach with the Utstein-style process proved to be extremely valuable in supporting content validity and representativeness. These results may facilitate the implementation and use of SBET in several countries.

TRIAL REGISTRATION

Not applicable.

Description, Organization, and Individual Postgraduate Perspectives of One Italian School of Anesthesia and Intensive Care

INTRODUCTION

The study aims to describe the organization of one accredited school of Anesthesia and Intensive Care of University of Modena and Reggio Emilia, Italy. The analysis of the post-graduation period aims to measure the time-to-first job, the perceived challenges, what postgraduate residents choose as first employ, and the overall satisfaction rating of a cohort of residents completing their training until 2017 with the usual and standard training program.

METHODS

We collected organization and administrative records of the five-year program of the A-IC School of 4 cohorts of residents who joined from 2009 to 2012 and we performed a survey. We also analyzed the differences among school cohorts during the medical training. In the end, it was investigated as a reason to choose hub hospitals or not.

RESULTS

The focus of the training activities revolved around the operating room with a mean of 30.41 ± 6.6 (sd), months followed by Intensive care with 17.29 ± 4.49 (sd) months. Although 7.5% of the respondents were not fully satisfied of the school's program, 89.7% of residents rated their training as adequate. In fact, 97.2% respondents reported they could overcome the professional challenges they faced after graduation. The multiple variables logistic regression showed a correlation among working in hub hospitals and training performed in university hospitals with a p value of 0.015.

CONCLUSION

This paper describes the postgraduation period. This point should be examined as an integral part of the accreditation procedure. Knowing the satisfaction rate, perception autonomy, and which type of hospitals are preferred can measure the education training capacity of a postgraduation school.

First steps towards international competency goals for residency training: a qualitative comparison of 3 regional standards in anesthesiology

BACKGROUND

Competency-based medical education (CBME) has revolutionized approaches to training by making expectations more concrete, visible, and relevant for trainees. Designing, applying, and updating CBME requirements challenges residency programs, which must address many aspects of training simultaneously. This challenge also exists for educational regulatory bodies in creating and adjusting national competencies to standardize training expectations. We propose that an international approach for mapping residency training requirements may provide a baseline for assessing commonalities and differences. This approach allows us to take our first steps towards creating international competency goals to enhance sharing of best practices in education and clinical work.

METHODS

We chose anesthesiology residency training as our example discipline. Using two rounds of content analysis, we qualitatively compared published anesthesiology residency competencies for the European Union (The European Training Requirement), United States (ACGME Milestones), and Canada (CanMEDS Competence By Design), focusing on similarities and differences in representation (round one) and emphasis (round two) to generate hypotheses on practical solutions regarding international educational standards.

RESULTS

We mapped the similarities and discrepancies between the three repositories. Round one revealed that 93% of competencies were common between the three repositories. Major differences between European Training Requirement, US Milestones, and Competence by Design competencies involved critical emergency medicine. Round two showed that over 30% of competencies were emphasized equally, with notable exceptions that European Training Requirement emphasized Anaesthesia Non-Technical Skills, Competence by Design highlighted more granular competencies within specific anesthesiology situations, and US Milestones emphasized professionalism and behavioral practices.

CONCLUSIONS

This qualitative comparison has identified commonalities and differences in anesthesiology training which may facilitate sharing broader perspectives on diverse high-quality educational, clinical, and research practices to enhance innovative approaches. Determining these overlaps in residency training can prompt international educational societies responsible for creating competencies to collaborate to design future training programs. This approach may be considered as a feasible method to build an international core of residency competency requirements for other disciplines.