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Zhang L, Xie D, Li B, Lei D, Zhu B, Hu J, Zheng J, Zhang J, Xu Y, Zuo Y, Song X. Pediatric anesthesia in China. Paediatr Anaesth 2024. [PMID: 38736282 DOI: 10.1111/pan.14902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 04/01/2024] [Accepted: 04/03/2024] [Indexed: 05/14/2024]
Abstract
In China, healthcare has lagged relative to its economic boom during the past 40 years. While the top tier hospitals offer pediatric perioperative care like high-income countries, lower-tier hospitals deliver lesser services of variable quality and safety related to equipment, supplies, clinician education, and availability. The national residency training program and the pediatric anesthesia fellowship program was established in 2013 and 2018 respectively. Increasing clinician workload from patient demand and a lack of consistency in quality and capability between rural and urban areas remain challenging.
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Affiliation(s)
- Liu Zhang
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Deying Xie
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Bo Li
- Department of Anesthesiology, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, National Children's Medical Center, Shanghai, China
| | - Dongxu Lei
- Department of Anesthesiology, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Bo Zhu
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Jing Hu
- Department of Anesthesiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Jijian Zheng
- Department of Anesthesiology, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, National Children's Medical Center, Shanghai, China
| | - Jianmin Zhang
- Department of Anesthesiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Ying Xu
- Department of Anesthesiology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Chongqing, China
| | - Yunxia Zuo
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Xingrong Song
- Department of Anesthesiology, Guangzhou Women and Children's Medical Center, Guangzhou, China
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Waugh E, Thomas J, Anderson BJ, Lee-Archer P. Pediatric anesthesia in Australia and New Zealand and health inequity among First Nations and Māori children. Paediatr Anaesth 2024. [PMID: 38655874 DOI: 10.1111/pan.14898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/30/2024] [Accepted: 04/01/2024] [Indexed: 04/26/2024]
Abstract
Australia and New Zealand are two countries in the Southern Pacific region. They share many pediatric anesthesia similarities in terms of medical organizational systems, education, training, and research, however there are important differences between the two nations in relation to geography, the First Nations populations and the history of colonization. While the standards for pediatric anesthesia and the specialty training requirements are set by the Australian and New Zealand College of Anesthetists and the Society for Pediatric Anesthesia in New Zealand and Australia, colonization has created distinct challenges that each nation now faces in order to improve the anesthetic care of its pediatric population. Australia generally has a high standard of living and good access to health care; disparities exist for First Nations People and for those living in rural or remote areas. Two influences have shaped training within New Zealand over the past 40 years; establishment of a national children's hospital in 1990 and, more importantly, acknowledgement that the First Nations people of New Zealand (Māori) have suffered because of failure to recognize their rights consequent to establishing a partnership treaty between Māori and the British Crown in 1840. Health inequities among Māori in New Zealand and First Nations People in Australia have implications for the health system, culturally appropriate approaches to treatment, and the importance of having an appreciation of First Nations people's history and culture, language, family structure, and cultural safety. Trainees in both countries need to be adequately supported in these areas in order for the sub-specialty of pediatric anesthesia to develop further and improve the anesthetic and surgical outcomes of our children.
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Affiliation(s)
- Edith Waugh
- Department of Anaesthesia and Perioperative Medicine, Royal Darwin and Palmerston Hospitals, Darwin, Northern Territory, Australia
| | - Jane Thomas
- Department of Anaesthesia, Starship Children's Hospital, Auckland, New Zealand
- The Auckland Regional Pain Service, Auckland, New Zealand
| | - Brian J Anderson
- Department of Anaesthesia, Starship Children's Hospital, Auckland, New Zealand
- Faculty of Medical and Health Sciences, Anaesthesiology, University of Auckland, Auckland, New Zealand
| | - Paul Lee-Archer
- Department of Anaesthesia, Children's Health Queensland Clinical Unit, Queensland Children's Hospital, Brisbane, Queensland, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
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Marty AP, Linsenmeyer M, George B, Young JQ, Breckwoldt J, Ten Cate O. Mobile technologies to support workplace-based assessment for entrustment decisions: Guidelines for programs and educators: AMEE Guide No. 154. MEDICAL TEACHER 2023; 45:1203-1213. [PMID: 36706225 DOI: 10.1080/0142159x.2023.2168527] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
With the rise of competency-based medical education and workplace-based assessment (WBA) since the turn of the century, much has been written about methods of assessment. Direct observation and other sources of information have become standard in many clinical programs. Entrustable professional activities (EPAs) have also become a central focus of assessment in the clinical workplace. Paper and pencil (one of the earliest mobile technologies!) to document observations have become almost obsolete with the advent of digital technology. Typically, clinical supervisors are asked to document assessment ratings using forms on computers. However, accessing these forms can be cumbersome and is not easily integrated into existing clinical workflows. With a call for more frequent documentation, this practice is hardly sustainable, and mobile technology is quickly becoming indispensable. Documentation of learner performance at the point of care merges WBA with patient care and WBA increasingly uses smartphone applications for this purpose.This AMEE Guide was developed to support institutions and programs who wish to use mobile technology to implement EPA-based assessment and, more generally, any type of workplace-based assessment. It covers backgrounds of WBA, EPAs and entrustment decision-making, provides guidance for choosing or developing mobile technology, discusses challenges and describes best practices.
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Affiliation(s)
| | - Machelle Linsenmeyer
- West Virginia School of Osteopathic Medicine, Lewisburg, WV, United States of America
| | - Brian George
- Surgery and Learning Health Sciences, University of Michigan, Ann Arbor, Michigan, United States of America
| | - John Q Young
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell &, Zucker Hillside Hospital, NY, United States of America
| | - Jan Breckwoldt
- Institute of Anesthesia at the University Hospital Zurich, Switzerland
| | - Olle Ten Cate
- Utrecht Center for Research and Development of Health Professions Education at UMC Utrecht, The Netherlands
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