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Raksakietisak M, Lertsiripatarajit V, Aroonpruksakul N, Plailaharn N, Raksamani K. Test-enhanced learning in Neuroanesthesia for the First Year anesthetic residents: a randomized controlled trial. BMC MEDICAL EDUCATION 2024; 24:905. [PMID: 39180040 PMCID: PMC11342467 DOI: 10.1186/s12909-024-05887-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 08/10/2024] [Indexed: 08/26/2024]
Abstract
BACKGROUND Test enhancing learning (TEL) had shown a significant effect in promoting the learning of many learning contents. However, its effect on the postgraduate medical level was unclear. This study aimed to investigate the effect of TEL in 1st year anesthesiology residents learning neuroanesthesia. METHOD The residents were randomized to either group A, which was assigned to do the intervention exam (exam A) for two times during learning in neuroanesthesia, or group B, which studied in the same environment without doing the exam. All participants were assigned to do the assessment exam (exam B) at one month after the end of the rotation. All of the exams were ten multiple choice questions (MCQ). Since the anesthesia residents rotated to neuroanesthesia for two weeks twice during the first year, we conducted the experiments twice, using exams that covered both basic science (BS) and clinical science (CS) topics. RESULTS There was no significant difference in mean ± SD of the scores for assessment exams asking about the basic science topic (BS_B) [group A (5.25 ± 2.05) VS group B (4.90 ± 1.80); p = 0.570] and the clinical science topic (CS_B) [group A (6.30 ± 1.26) VS group B (5.95 ± 1.61); p = 0.448]. CONCLUSION This study showed null findings on the effect of TEL on learning in residents of the first year of anesthesiology. More studies on TEL were required to confirm the effect of TEL and find the appropriate test format that could enhance learning for post-graduate medical trainees.
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Affiliation(s)
- Manee Raksakietisak
- Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangok Noi, Bangkok, 10700, Thailand
| | - Vasu Lertsiripatarajit
- Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangok Noi, Bangkok, 10700, Thailand
| | - Naiyana Aroonpruksakul
- Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangok Noi, Bangkok, 10700, Thailand
| | - Narin Plailaharn
- Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Kasana Raksamani
- Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangok Noi, Bangkok, 10700, Thailand.
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de Oliveira Filho GR, Soares Garcia JH. The Accuracy of the Learning-Curve Cumulative Sum Method in Assessing Brachial Plexus Block Competency. Anesth Analg 2024; 139:281-290. [PMID: 38861983 DOI: 10.1213/ane.0000000000006928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
BACKGROUND The learning-curve cumulative sum method (LC-CUSUM) and its risk-adjusted form (RA-LC-CUSUM) have been proposed as performance-monitoring methods to assess competency during the learning phase of procedural skills. However, scarce data exist about the method's accuracy. This study aimed to compare the accuracy of LC-CUSUM forms using historical data consisting of sequences of successes and failures in brachial plexus blocks (BPBs) performed by anesthesia residents. METHODS Using historical data from 1713 BPB performed by 32 anesthesia residents, individual learning curves were constructed using the LC-CUSUM and RA-LC-CUSUM methods. A multilevel logistic regression model predicted the procedure-specific risk of failure incorporated in the RA-LC-CUSUM calculations. Competency was defined as a maximum 15% cumulative failure rate and was used as the reference for determining the accuracy of both methods. RESULTS According to the LC-CUSUM method, 22 residents (84.61%) attained competency after a median of 18.5 blocks (interquartile range [IQR], 14-23), while the RA-LC-CUSUM assigned competency to 20 residents (76.92%) after a median of 17.5 blocks (IQR, 14-25, P = .001). The median failure rate at reaching competency was 6.5% (4%-9.75%) under the LC-CUSUM and 6.5% (4%-9%) for the RA-LC-CUSUM method ( P = .37). The sensitivity of the LC-CUSUM (85%; 95% confidence interval [CI], 71%-98%) was similar to the RA-LC-CUSUM method (77%; 95% CI, 61%-93%; P = .15). Identical specificity values were found for both methods (67%; 95% CI, 29%-100%, P = 1). CONCLUSIONS The LC-CUSUM and RA-LC-CUSUM methods were associated with substantial false-positive and false-negative rates. Also, small lower limits for the 95% CIs around the accuracy measures were observed, indicating that the methods may be inaccurate for high-stakes decisions about resident competency at BPBs.
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Abramovich I, Crisan I, Sobreira Fernandes D, De Hert S, Lukic A, Norte G, Matias B, Majić M, Berger-Estilita J. Anaesthesia training designs across Europe: A survey-based study from the trainees committee of the European Society of Anaesthesiology and Intensive Care. REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 2024; 71:427-437. [PMID: 38636795 DOI: 10.1016/j.redare.2024.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 08/13/2023] [Indexed: 04/20/2024]
Abstract
BACKGROUND Anaesthesiology training programs in Europe vary in duration, content, and requirements for completion. This survey-based study conducted by the Trainees Committee of the European Society of Anaesthesiology and Intensive Care explores current anaesthesia training designs across Europe. METHODS Between May and July 2018, we sent a 41-item online questionnaire to all National Trainee Representatives, members of the National Anaesthesiologists Societies Committee, and Council Representatives of the European Society of Anaesthesiology and Intensive Care (ESAIC) of all member countries. We cross-validated inconsistent data with different country representatives. RESULTS Forty-three anaesthesiologists from all 39 associated ESAIC countries completed the questionnaire. Results showed considerable variability in teaching formats, frequency of teaching sessions during training, and differences in assessments made during and at the end of training. The reported duration of training was 60 months in 59% (n = 23) of participating countries, ranging from 24 months in Russia and Ukraine to 84 months in the UK. CONCLUSION This study shows the significant differences in anaesthesiology training formats across Europe, and highlights the importance of developing standardised training programs to ensure a consistent level of training and to improve patient safety. This study provides valuable insights into European anaesthesia training, and underlines the need for further research and collaboration to improve requirements.
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Affiliation(s)
- I Abramovich
- Charité - Universitätsmedizin Berlin, Department of Anaesthesiology and Intensive Care Medicine (CCM/CVK), Berlin, Germany.
| | - I Crisan
- Universitätsspital Zürich, Department of Emergency Medicine, Zürich, Switzerland
| | - D Sobreira Fernandes
- Centro Hospitalario de Póvoa de Varzim y Vila de Conde, Póvoa de Varzim, Portugal
| | - S De Hert
- Department of Anaesthsiology and Peri-operative Medicine, Ghent University, Ghent, Belgium
| | - A Lukic
- Department of Anaesthesiology, Reanimateology and Intensive Care, General Hospital Varaždin, Varaždin, Croatia
| | - G Norte
- Department of Anaesthesiology, Centro Hospitalar Trás-os-Montes y Alto Douro, Vila Real, Portugal
| | - B Matias
- Department of Anaesthesiology, Centro Hospitalar de Setúbal, Setúbal, Portugal
| | - M Majić
- Department of Anaesthesiology and ICU, University Hospital Centre Zagreb, Zagreb, Croatia
| | - J Berger-Estilita
- Institute for Medical Education, University of Bern, Bern, Switzerland; Institute of Anaesthsiology and Intensive Care, Salemspital, Hirslanden Medical Group, Bern, Switzerland; CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, Porto, Portugal
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4
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Fuller SL, Ambardekar AP, Diachun CAB, Kearney MD, Long TR, Miller Juve AK, Mitchell JD, Woodworth GE. Competency-Based Time-Variable Anesthesiology Residency Training: Identification of Problems and Solutions. Anesth Analg 2024; 138:848-855. [PMID: 37450642 DOI: 10.1213/ane.0000000000006625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
BACKGROUND Global medical education is gradually moving toward more comprehensive implementations of a competency-based education (CBE) model. Elimination of standard time-based training and adoption of time-variable training (competency-based time-variable training [CB-TVT]) is one of the final stages of implementation of CBE. While CB-TVT has been implemented in some programs outside the United States, residency programs in the United States are still exploring this approach to training. The Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Medical Specialties (ABMS) are encouraging member boards and residency review committees to consider innovative ways programs could implement CB-TVT. The goals of this study were to (1) identify potential problems with the implementation of CB-TVT in anesthesiology residency training, (2) rank the importance of the problems and the perceived difficulty of solving them, and (3) develop proposed solutions to the identified problems. METHODS Study participants were recruited from key stakeholder groups in anesthesiology education, including current or former program directors, department chairs, residents, fellows, American Board of Anesthesiology (ABA) board members, ACGME residency review committee members or ACGME leaders, designated institutional officials, residency program coordinators, clinical operations directors, and leaders of large anesthesiology community practice groups. This study was conducted in 2 phases. In phase 1, survey questionnaires were iteratively distributed to participants to identify problems with the implementation of CB-TVT. Participants were also asked to rank the perceived importance and difficulty of each problem and to identify relevant stakeholder groups that would be responsible for solving each problem. In phase 2, surveys focused on identifying potential solutions for problems identified in phase 1. RESULTS A total of 36 stakeholders identified 39 potential problems, grouped into 7 major categories, with the implementation of CB-TVT in anesthesiology residency training. Of the 39 problems, 19 (48.7%) were marked as important or very important on a 5-point scale and 12 of 19 (63.2%) of the important problems were marked as difficult or very difficult to solve on a 5-point scale. Stakeholders proposed 165 total solutions to the identified problems. CONCLUSIONS CB-TVT is a promising educational model for anesthesiology residency, which potentially results in learner flexibility, individualization of curricula, and utilization of competencies to determine learner advancement. Because of the potential problems with the implementation of CB-TVT, it is important for future pilot implementations of CB-TVT to document realized problems, efficacy of solutions, and effects on educational outcomes to justify the burden of implementing CB-TVT.
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Affiliation(s)
- Skylar L Fuller
- From the Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, Oregon
| | - Aditee P Ambardekar
- Department of Anesthesiology and Pain Management, University of Texas, Southwestern Medical Center, Dallas, Texas
| | - Carol Ann B Diachun
- Department of Anesthesiology, University of Florida-Jacksonville, Jacksonville, Florida
| | - Matthew D Kearney
- Department of Family Medicine and Community Health, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Timothy R Long
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota
| | - Amy K Miller Juve
- From the Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, Oregon
| | - John D Mitchell
- Department of Anesthesiology, Critical Care, and Perioperative Medicine, Henry Ford Health, Detroit, Michigan
| | - Glenn E Woodworth
- From the Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, Oregon
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Gu Y, Tenenbein M, Korz L, Busse JW, Chiu M. Simulation-based medical education in Canadian anesthesiology academic institutions: a national survey. Can J Anaesth 2024:10.1007/s12630-024-02720-6. [PMID: 38453798 DOI: 10.1007/s12630-024-02720-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 12/04/2023] [Accepted: 12/05/2023] [Indexed: 03/09/2024] Open
Abstract
PURPOSE Simulation-based medical education (SBME) is provided by all anesthesiology residency programs in Canada. The purpose of this study was to characterize SBME in Canadian anesthesiology residency training programs. METHODS We administered a 21-question survey to the simulation director/coordinator for all 17 Canadian academic departments of anesthesiology from October 2019 to January 2020. The survey consisted of questions pertaining to the characteristics of the simulation centres, their faculty, learners, curriculum, and assessment processes. RESULTS All 17 residency training programs participated in the survey and reported large variability in the number and formal training of simulation faculty and in content delivery. Five programs (29%) did not provide faculty recognition for curriculum design and running simulation sessions. Most programs offered one to four simulation sessions per academic year for each year of residency. All programs offered mannequin-based and part-task trainers for teaching technical and nontechnical skills. Fourteen programs (82%) offered interprofessional and interdisciplinary simulation sessions, and ten programs (59%) did not include in situ simulation training. Commonly reported barriers to faculty involvement were lack of protected time (12 programs, 71%), lack of financial compensation (ten programs, 59%), and lack of appreciation for SBME (seven programs, 41%). CONCLUSION Large variability exists in the delivery of SBME in Canadian anesthesiology residency simulation programs, in part because of differences in financial/human resources and educational content. Future studies should explore whether training and patient outcomes differ between SBME programs and, if so, whether additional standardization is warranted.
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Affiliation(s)
- Yuqi Gu
- Department of Anesthesiology and Pain Medicine, University of Ottawa and The Ottawa Hospital, 501 Smyth Rd, Critical Care Wing 1401, Ottawa, ON, K1H 8L6, Canada.
| | - Marshall Tenenbein
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Linda Korz
- Department of Anesthesia, McMaster University, Hamilton, ON, Canada
| | - Jason W Busse
- Department of Anesthesia, McMaster University, Hamilton, ON, Canada
| | - Michelle Chiu
- Department of Anesthesiology and Pain Medicine, University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada
- Department of Innovation in Medical Education, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
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6
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Sahi N, Humphrey-Murto S, Brennan EE, O'Brien M, Hall AK. Current use of simulation for EPA assessment in emergency medicine. CAN J EMERG MED 2024; 26:179-187. [PMID: 38374281 DOI: 10.1007/s43678-024-00649-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 01/12/2024] [Indexed: 02/21/2024]
Abstract
OBJECTIVE Approximately five years ago, the Royal College emergency medicine programs in Canada implemented a competency-based paradigm and introduced the use of Entrustable Professional Activities (EPAs) for assessment of units of professional activity to assess trainees. Many competency-based medical education (CBME) based curricula, involve assessing for entrustment through observations of EPAs. While EPAs are frequently assessed in clinical settings, simulation is also used. This study aimed to characterize the use of simulation for EPA assessment. METHODS A study interview guide was jointly developed by all study authors and followed best practices for survey development. A national interview was conducted with program directors or assistant program directors across all the Royal College emergency medicine programs across Canada. Interviews were conducted over Microsoft Teams, interviews were recorded and transcribed, using Microsoft Teams transcribing service. Sample transcripts were analyzed for theme development. Themes were then reviewed by co-authors to ensure they were representative of the participants' views. RESULTS A 64.7% response rate was achieved. Simulation has been widely adopted by EM training programs. All interviewees demonstrated support for the use of simulation for EPA assessment for many reasons, however, PDs acknowledged limitations and thematic analysis revealed certain themes and tensions for using simulation for EPA assessment. Thematic analysis revealed six major themes: widespread support for the use of simulation for EPA assessment, concerns regarding the potential for EPA assessment to become a "tick- box" exercise, logistical barriers limiting the use of simulation for EPA assessment, varied perceptions about the authenticity of using simulation for EPA assessment, the potential for simulation for EPA assessment to compromise learner psychological safety, and suggestions for the optimization of use of simulation for EPA assessment. CONCLUSIONS Our findings offer insight for other programs and specialties on how simulation for EPA assessment can best be utilized. Programs should use these findings when considering using simulation for EPA assessment.
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Affiliation(s)
- Nidhi Sahi
- Department of Innovation in Medical Education (DIME), University of Ottawa, Ottawa, ON, Canada.
| | - Susan Humphrey-Murto
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
- Tier 2 Research Chair in Medical Education and Fellowship Director, Medical Education Research, University of Ottawa, Ottawa, ON, Canada
| | - Erin E Brennan
- Department of Emergency Medicine, Queen's University, Kingston, ON, Canada
| | - Michael O'Brien
- Emergency Medicine, The Ottawa Hospital, Ottawa, ON, Canada
- Department of Innovation in Medical Education, University of Ottawa, Ottawa, ON, Canada
| | - Andrew K Hall
- Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
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7
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Benhamou D, Mercier FJ, Van de Velde M, Lucas N, Sng BL, Gaiser R. Education in obstetric anesthesiology: an international approach. Int J Obstet Anesth 2023; 55:103896. [PMID: 37270857 DOI: 10.1016/j.ijoa.2023.103896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/26/2023] [Accepted: 04/24/2023] [Indexed: 06/06/2023]
Abstract
Competency-based training and active teaching methods are increasingly becoming accepted and utilized in medical schools and hospitals, and obstetric anesthesiology training is expected to follow this process. This article summarizes current modalities of obstetric anesthesiology training in five countries from various parts of the world. Analysis of these curricula shows that implementation of new educational methods is variable, incomplete, and lacking in data related to patient outcomes. Research in assessments and practical applications are required to avoid wide ranges of educational strategies.
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Affiliation(s)
- D Benhamou
- Service d'Anesthésie Réanimation Médecine Péri Opératoire, AP-HP.Université Paris Saclay, Hôpital Bicêtre, Le Kremlin Bicêtre Cedex, France.
| | - F J Mercier
- Service d'Anesthésie Réanimation Médecine Péri Opératoire, AP-HP.Université Paris Saclay, Hôpital Antoine Béclère, Clamart Cedex, France
| | - M Van de Velde
- Department of Cardiovascular Sciences, KU Leuven, and Department of Anaesthesiology, UZ Leuven, Leuven, Belgium
| | - N Lucas
- London North West Healthcare NHS Trust, United Kingdom
| | - B L Sng
- Anesthesiology and Perioperative Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore and Department of Women's Anaesthesia, KK Women's and Children's Hospital, Singapore
| | - R Gaiser
- Yale School of Medicine, New Haven, CT, USA
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8
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Malik A, Kohli M, Sood J, Singh B, Radhakrishnan B, Kanchi M. Postgraduate training in anaesthesiology - A modular curriculum. Indian J Anaesth 2023; 67:548-555. [PMID: 37476448 PMCID: PMC10355357 DOI: 10.4103/ija.ija_674_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 03/10/2023] [Accepted: 03/11/2023] [Indexed: 07/22/2023] Open
Abstract
The primary objective of postgraduate medical education is to produce specialists who provide highest quality of health care to suffering patients and return them to the community in the most functional capability. The secondary objective is to advance the cause of science through research and training. A postgraduate, after undergoing the required training in anaesthesiology, should be able to recognise the health needs of the community and apply cognitive and psychomotor skills to provide optimal anaesthetic care. Additionally, the anaesthesiologist should function as a perioperative physician being adept in perioperative care, pain medicine and critical care medicine. The 3-year postgraduate curriculum comprises experience in basic, subspeciality and advanced anaesthesia training. This structured training programme with a curriculum of increasing difficulty and learning incorporates ascending grades of difficulty, posing a challenge to the trainee's intellect and technical skills. Experience in basic anaesthesia training is aimed to lay stress on basic and fundamental aspects of anaesthetic management. Subspeciality anaesthesia training is needed to lay stress on the theory, special considerations and practice of subdisciplines of anaesthesiology. This document proposes a modular-structured, continuous, objectively evaluated, systematic training process that is monitored frequently and periodically, such that the trainee, at the end of training, is capable of appropriate anaesthetic management of disease conditions in a wide variety of situations.
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Affiliation(s)
- Anita Malik
- Anaesthesiology and Critical Care, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Monica Kohli
- Anaesthesiology and Critical Care, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Jayashree Sood
- Chairperson, Institute of Anaesthesiology, Pain and Perioperative Medicine, Sir Gangaram Hospital, New Delhi, India
| | - Baljit Singh
- Department of Anaesthesiology, SGT Medical College Hospital and Research Institute, Gurugram, Haryana, India
| | | | - Muralidhar Kanchi
- Department of Anaesthesiology and Intensive Care, Narayana Institute of Cardiac Sciences, Narayana Health City, Bengaluru, Karnataka, India
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9
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Patel SJ, Notarianni AP, Martin AK, Tsai A, Pulton DA, Linganna R, Patel PA, Waldron NH, Nimma SR, Bodmer NJ, Kothari P, Jackson E, Gupta RG, Roberts ML, Feinman JW. The Year in Graduate Medical Education: Selected Highlights From 2022. J Cardiothorac Vasc Anesth 2023:S1053-0770(23)00275-6. [PMID: 37210326 DOI: 10.1053/j.jvca.2023.04.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 04/28/2023] [Indexed: 05/22/2023]
Affiliation(s)
- Saumil J Patel
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, Philadelphia, PA
| | - Andrew P Notarianni
- Department of Anesthesiology, Cardiothoracic Division, Yale University School of Medicine, New Haven, CT
| | - Archer Kilbourne Martin
- Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL
| | - Albert Tsai
- Department of Anesthesiology, Perioperative and Pain Medicine, Division of Cardiothoracic Anesthesiology, Stanford University School of Medicine, Stanford, CA
| | - Danielle A Pulton
- Department of Anesthesiology, Temple University Hospital/Lewis Katz School of Medicine, Philadelphia, PA
| | - Regina Linganna
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, Philadelphia, PA
| | - Prakash A Patel
- Department of Anesthesiology, Cardiothoracic Division, Yale University School of Medicine, New Haven, CT
| | - Nathan H Waldron
- Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL
| | - Sindhuja R Nimma
- Division of Regional Anesthesiology and Acute Pain Medicine, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL
| | - Natalie J Bodmer
- Department of Anesthesiology, Perioperative and Pain Medicine, Division of Cardiothoracic Anesthesiology, Stanford University School of Medicine, Stanford, CA
| | - Perin Kothari
- Department of Anesthesiology, Perioperative and Pain Medicine, Division of Cardiothoracic Anesthesiology, Stanford University School of Medicine, Stanford, CA
| | - Ethan Jackson
- Department of Anesthesiology, Perioperative and Pain Medicine, Division of Cardiothoracic Anesthesiology, Stanford University School of Medicine, Stanford, CA
| | - Ragini G Gupta
- Department of Anesthesiology, Temple University Hospital/Lewis Katz School of Medicine, Philadelphia, PA
| | - Monique L Roberts
- Department of Anesthesiology, Temple University Hospital/Lewis Katz School of Medicine, Philadelphia, PA
| | - Jared W Feinman
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, Philadelphia, PA.
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10
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Dabbagh A, Fadaeizadeh L, Gharaei B, Ghasemi M, Kamranmanesh M, Khorasanizadeh S, Massoudi N, Mahdavi SA, Memary E, Moshari M, Nashibi M, Sezari P, Vosoughian M. The Role of Entrustable Professional Activities in Competency-based Medical Education for Anesthesiology Residents: A Pilot Phase. Anesth Pain Med 2022; 12:e130176. [PMID: 36937177 PMCID: PMC10016108 DOI: 10.5812/aapm-130176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 10/31/2022] [Accepted: 11/08/2022] [Indexed: 12/26/2022] Open
Abstract
Background After graduation, physicians should be able to provide professional and safe services without the need for supervision by their clinical professors, mandating a competency-based medical education (CBME) approach. Objectives This study aimed to develop a national model of entrustable professional activities (EPAs) based on our experiences in the Department of Anesthesiology and Critical Care (DACC), Shahid Beheshti University of Medical Sciences (SBMU). Methods The primary EPA design plan was designed in a 10-step model as a career roadmap for the project. The texts were prepared according to a consensus-based approach. On the other hand, the texts were reviewed and revised by a broad team of faculty in a daily workshop. Results The final product included 14 topics for EPA as the first round of targeting topics for anesthesiology residents. The texts were developed using previous studies and were standardized considering national standards. Conclusions We described a clear path toward designing and implementing EPAs in anesthesiology residency programs to improve the quality of the graduated residents. Though the basic theory is the same, each country needs its formula for implementing the process.
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Affiliation(s)
- Ali Dabbagh
- Anesthesiology Department, Anesthesiology Research Center, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Corresponding Author: Anesthesiology Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Lida Fadaeizadeh
- Department of Anesthesiology, School of Medicine, Telemedicine Research Center, National Research Institute of Tuberculosis and Lung Diseases, Dr. Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Babak Gharaei
- Anesthesiology Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahshid Ghasemi
- Anesthesiology Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Kamranmanesh
- Anesthesiology Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shayesteh Khorasanizadeh
- Anesthesiology Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nilofar Massoudi
- Anesthesiology Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Alireza Mahdavi
- Anesthesiology Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elham Memary
- Anesthesiology Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Moshari
- Anesthesiology Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoud Nashibi
- Anesthesiology Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parissa Sezari
- Anesthesiology Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Vosoughian
- Anesthesiology Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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11
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Orser BA, Spadafora SM. Competence-Based Training and Immersion Virtual Reality: Paradigm-Shifting Advances in Medical Education. Anesth Analg 2022; 135:220-222. [PMID: 35839491 DOI: 10.1213/ane.0000000000006116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Beverley A Orser
- From the Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Anesthesia, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Salvatore M Spadafora
- From the Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Anesthesia and Pain Management, Mount Sinai Hospital, University Health Network, Toronto, Ontario, Canada
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Nathan N. Looking Ahead to the Frontier of Anesthesiology Education. Anesth Analg 2022; 135:219. [PMID: 35839490 DOI: 10.1213/ane.0000000000006137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
In this issue of Anesthesia & Analgesia, a series of articles focus on the elemental changes to anesthesia training and education. Kealey and Naik review the status of competency-based medical training, a method through which learners are deliberately observed for progression to mastery in clinical management. This is contrast to the assumption that trainees will presumably reach the same intended endpoint merely by spending a pre-specified amount of time in post-graduate residency training. The advantages and disadvantages of the competency-based approach are reviewed. Alam and Matava describe how education has also changed to incorporate digital technology by way of immersive simulation. They detail the use of virtual and augmented reality to offer trainees the opportunity to engage in clinical exercises that are infrequently encountered in real practice, increase the exposure to challenging scenarios and foster real-time collaborations on a global scale. An accompanying editorial offers further perspective on the future of training in our specialty. The reader is strongly encouraged to review the cited articles for an in-depth appreciation of the concepts discussed.
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Affiliation(s)
- Naveen Nathan
- Northwestern University Feinberg School of Medicine ( )
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