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Komasawa N, Yokohira M. Impact of Career Design Simulation on Japanese Medical Students: An Educational Study. Cureus 2024; 16:e65382. [PMID: 39184728 PMCID: PMC11344639 DOI: 10.7759/cureus.65382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2024] [Indexed: 08/27/2024] Open
Abstract
BACKGROUND The present study aimed to evaluate the effect of career design simulation on the attitude of Japanese medical students toward doctoral life planning, including qualification acquisition. METHODS In this study, we conducted a career-design simulation trial with fourth-year medical students. The three-hour course comprised lectures on career design and individual career design, including an ideal plan and a modified plan according to unexpected work and life events, as well as group discussions. Nine questions regarding career design attitude (awareness, significance, or intention to acquire a doctoral degree or medical specialty, work-life balance, and flexibility) were answered in both pre- and post-career design simulation training. RESULTS The response rate was 67.5% (79/117). Attitudes toward career design significantly improved after the career design simulation, regardless of the duration after graduation (p < 0.001, each). Attitudes toward the significance of doctorate degrees significantly improved after participation (p = 0.007), while attitudes toward medical specialties did not (p = 0.128). In contrast, confidence in obtaining a medical specialty and doctoral degree was improved by career design simulations (p = 0.009 and p = 0.003, respectively). CONCLUSION These findings suggest that career design simulations can be an effective educational method for developing active learning, motivation for career image, and lifelong education.
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Affiliation(s)
- Nobuyasu Komasawa
- Community Medicine Education Promotion Office, Faculty of Medicine, Kagawa University, Miki-cho, JPN
| | - Masanao Yokohira
- Department of Medical Education, Kagawa University, Miki-cho, JPN
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Yan L, Karamchandani K, Gaiser RR, Carr ZJ. Identifying, Understanding, and Minimizing Unconscious Cognitive Biases in Perioperative Crisis Management: A Narrative Review. Anesth Analg 2024; 139:68-77. [PMID: 37874227 DOI: 10.1213/ane.0000000000006666] [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: 10/25/2023]
Abstract
Rapid clinical decision-making behavior is often based on pattern recognition and other mental shortcuts. Although such behavior is often faster than deliberative thinking, it can also lead to errors due to unconscious cognitive biases (UCBs). UCBs may contribute to inaccurate diagnoses, hamper interpersonal communication, trigger inappropriate clinical interventions, or result in management delays. The authors review the literature on UCBs and discuss their potential impact on perioperative crisis management. Using the Scale for the Assessment of Narrative Review Articles (SANRA), publications with the most relevance to UCBs in perioperative crisis management were selected for inclusion. Of the 19 UCBs that have been most investigated in the medical literature, the authors identified 9 that were judged to be clinically relevant or most frequently occurring during perioperative crisis management. Formal didactic training on concepts of deliberative thinking has had limited success in reducing the presence of UCBs during clinical decision-making. The evolution of clinical decision support tools (CDSTs) has demonstrated efficacy in improving deliberative clinical decision-making, possibly by reducing the intrusion of maladaptive UCBs and forcing reflective thinking. Anesthesiology remains a leader in perioperative crisis simulation and CDST implementation, but spearheading innovations to reduce the adverse impact of UCBs will further improve diagnostic precision and patient safety during perioperative crisis management.
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Affiliation(s)
- Luying Yan
- From the Yale University School of Medicine, New Haven, Connecticut
| | - Kunal Karamchandani
- Department of Anesthesiology
- University of Texas, Southwestern Medical School, Dallas, Texas
| | - Robert R Gaiser
- From the Yale University School of Medicine, New Haven, Connecticut
- Department of Anesthesiology
| | - Zyad J Carr
- From the Yale University School of Medicine, New Haven, Connecticut
- Department of Anesthesiology
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Robben N, Dierick-van Daele ATM, Bouwman ARA, van Loon FHJ. Worry as Important "Feelers" in Clinical Anesthesia Practice: A Mixed-Methods Study. J Perianesth Nurs 2024:S1089-9472(24)00011-X. [PMID: 38691073 DOI: 10.1016/j.jopan.2024.01.004] [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: 11/10/2023] [Revised: 01/08/2024] [Accepted: 01/08/2024] [Indexed: 05/03/2024]
Abstract
PURPOSE Worry is an intuitive sense that goes beyond logical reasoning and is valuable in situations where patients' conditions are rapidly changing or when objective data may not fully capture the complexity of a patient's situation. Nurse anesthetists' subjective reasons for worry are quite vague as they are valued inconsistently and not accurately expressed. This study aimed to identify factors playing a role in the emergence of worry during anesthesia practice to clarify its concept. DESIGN Mixed-methods design consisting of quantitative online surveys followed by qualitative focus group interviews including Dutch nurse anesthetists. METHODS Both quantitative and qualitative thematic analyses were performed, followed by data and methodological triangulation to enhance the validity and credibility of findings and mitigate the presence of bias. FINDINGS Surveys (N = 102) were analyzed, and 14 nurse anesthetists participated in the focus group interviews. A total of 89% of the survey respondents reported that at least once have had the feeling of worry, of which 92% use worry during clinical anesthesia practice. Worry was mentioned to be a vital element during anesthesia practice that makes it possible to take precautionary actions to change the anesthetic care plan in a changing situation or patient deterioration. CONCLUSIONS While a clear definition of worry could not be given, it is a valuable element of anesthesia practice as it serves as a catalyst for critical thinking, problem-solving, clinical reasoning, and decision-making. Use of the feeling of worry alongside technological systems to make an informed decision is crucial. Technology has significantly improved the ability of health care providers to detect and respond to patient deterioration promptly, but it is crucial for nurse anesthetists to use their feeling of worry or intuition alongside technological systems and evidence-based practice to ensure quick assessments or judgments based on experience, knowledge, and observations in clinical practice.
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Affiliation(s)
- Noa Robben
- Department of Anesthesiology, Catharina Hospital, Eindhoven, North-Brabant, The Netherlands
| | - Angelique T M Dierick-van Daele
- Institute of People and Health Sciences, Fontys University of Applied Sciences, Eindhoven, North-Brabant, The Netherlands; Research Department, Catharina Hospital, Eindhoven, North-Brabant, The Netherlands
| | - Arthur R A Bouwman
- Department of Anesthesiology, Catharina Hospital, Eindhoven, North-Brabant, The Netherlands; Department of Signal Processing Systems and Electrical Engineering, TU/e University of Technology, Eindhoven, North-Brabant, The Netherlands
| | - Fredericus H J van Loon
- Department of Anesthesiology, Catharina Hospital, Eindhoven, North-Brabant, The Netherlands; Department of Perioperative Care and Technology of the Institute of People and Health Sciences, Fontys University of Applied Sciences, Eindhoven, North-Brabant, The Netherlands.
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Komasawa N. Revitalizing Postoperative Pain Management in Enhanced Recovery After Surgery via Inter-departmental Collaboration Toward Precision Medicine: A Narrative Review. Cureus 2024; 16:e59031. [PMID: 38800337 PMCID: PMC11127797 DOI: 10.7759/cureus.59031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2024] [Indexed: 05/29/2024] Open
Abstract
This narrative review explores the crucial aspects of postoperative pain management within the framework of Enhanced Recovery After Surgery (ERAS). It emphasizes the significance of effective and secure pain management, highlighting its impact on patient well-being, surgical outcomes, and hospital stays. The inadequacy of perioperative pain relief increases the risk of persistent postoperative pain, emphasizing the need to challenge the notion that pain is expected after surgery. The goals of postoperative pain management extend beyond mere relief, encompassing comfortable sleep, pain-free rest, and liberation from pain during initial recovery. Inadequate pain management can lead to complications such as heightened postoperative bleeding and an increased risk of thrombosis. The review delves into various analgesic methods, their complications, and safety measures. ERAS programs, focused on reducing complications and medical costs, emphasize the importance of judicious postoperative pain management and active rehabilitation. The review discusses complications associated with analgesic methods like opioids, epidural analgesia, and adjuvant analgesics. Collaboration within the perioperative management team is crucial for effective postoperative pain relief. Interdepartmental collaboration is essential for evaluating surgical procedures, analgesic methods, and crisis management strategies. The review concludes by integrating precision medicine into postoperative pain management, emphasizing the potential of genetic information in assessing pain sensitivity. It underscores the importance of inter-departmental collaboration and information gathering for the successful implementation of precision medicine tailored to each facility's perioperative management systems. Additionally, the impact of artificial intelligence (AI) on preoperative risk assessment and innovative monitoring techniques is discussed, paving the way for the advancement of precision medicine in postoperative pain management.
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Affiliation(s)
- Nobuyasu Komasawa
- Community Medicine Education Promotion Office, Faculty of Medicine, Kagawa University, Miki-cho, JPN
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Komasawa N, Yokohira M. Attitude toward career development in Japanese medical students: a questionnaire survey. BMJ Open 2024; 14:e076982. [PMID: 38216194 PMCID: PMC10806647 DOI: 10.1136/bmjopen-2023-076982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 12/28/2023] [Indexed: 01/14/2024] Open
Abstract
OBJECTIVES The study aimed to evaluate attitudes of Japanese medical students toward career development, including the acquisition of medical specialty and doctorate degree qualifications. DESIGN This involved a web-based questionnaire survey. SETTING We asked medical students about attitudes toward career development after graduation. We also asked them about their intentions to acquire a medical specialty and a doctorate degree using a 5-point Likert scale. PARTICIPANTS All 699 medical students (from first to sixth grade) in our medical school. RESULTS The overall questionnaire response rate was 66.5% (465 of 699). Over 90.3% (420 of 465) of respondents desired the clinical discipline, while only 10 of 465 respondents (2.2%) did for basic research. Awareness of career development for ≥8 years after graduation was significantly lower compared with that for 1-2 years after graduation among fourth-sixth year students (fourth p=0.0023, fifth p<0.001, sixth p<0.001). Awareness of career development for 3-7 years after graduation was significantly lower compared with that for 1-2 years after graduation among third-sixth year students (third p<0.001, fourth p=0.003, fifth p<0.001, sixth p<0.001). In the sixth year medical students, only 10.3% showed strong awareness of career development for ≥8 years after graduation, while 39.7% of them did for 1-2 years after graduation. Intentions to acquire a doctorate degree were significantly weaker than those for a medical specialty in all years (p<0.001 in all grades). CONCLUSION Most Japanese medical students concentrated on the 2-year initial training period immediately after graduation, with vague plans for the subsequent years. Intentions to acquire a doctoral degree were significantly lower than those for a medical specialty. Our findings underscore the necessity for a comprehensive, longitudinal and systematic career development programme.
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Affiliation(s)
- Nobuyasu Komasawa
- Department of Medical Education, Kagawa Daigaku, Takamatsu, Kagawa, Japan
| | - Masanao Yokohira
- Department of Medical Education, Kagawa Daigaku, Takamatsu, Kagawa, Japan
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Komasawa N, Yokohira M. Survey on Medical Students' Attitudes Toward Medical Practice Just Before Clinical Clerkship in Japan. Cureus 2024; 16:e52899. [PMID: 38406098 PMCID: PMC10891475 DOI: 10.7759/cureus.52899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2024] [Indexed: 02/27/2024] Open
Abstract
INTRODUCTION The present study examined the confidence in essential medical practices during clinical clerkship (CC) and performance in preparing education for medical students who are just starting CC at our university. METHODS We conducted a survey using questionnaires with 105 fourth-year medical students just before starting CC. This questionnaire analysis consists of the confidence in objective structured clinical examination (OSCE) and computer-based testing (CBT) performance toward essential medical practice recommended in the "Report on Medical Practice during Clinical Clerkship" by the Japanese Ministry of Health, Labor, and Welfare and medical safety for CC. RESULTS The response rate was 67.6% (71/105). As for the performance in each OSCE theme, the confidence in basic clinical technique was significantly smaller compared to chest or abdominal examination, medical interview, and emergency response (p<0.05 each). Medical interviews showed stronger confidence compared to gynecological, breast, or rectal examinations and prostate palpitation among medical examinations (p<0.05 each). In the basic technique during CC, skin disinfection showed stronger confidence compared to other techniques (p<0.05 each). On surgical technique during CC, surgical hand washing and gown technique significantly showed stronger confidence compared to skin suture, suture removal, bleeding control, and surgical assistant (p<0.05 each). CONCLUSION Our results suggest that medical students just before CC have less confidence in invasive medical practice during CC. As medical practice by student doctors becomes public, further systematic basic skill training both before and during CC is warranted.
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Affiliation(s)
- Nobuyasu Komasawa
- Community Medicine Education Promotion Office, Faculty of Medicine, Kagawa University, Takamatsu, JPN
| | - Masanao Yokohira
- Department of Medical Education, Faculty of Medicine, Kagawa University, Takamatsu, JPN
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Zhan HQ, Zhang XX, Qin R, Fei J, Dong GY, Hao JH. Application of integrated problem-based learning combined with lecture-based classroom teaching in undergraduate medical education: An effective teaching model in a Medical School in China. Medicine (Baltimore) 2023; 102:e34792. [PMID: 37653783 PMCID: PMC10470717 DOI: 10.1097/md.0000000000034792] [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: 05/17/2023] [Revised: 07/03/2023] [Accepted: 07/26/2023] [Indexed: 09/02/2023] Open
Abstract
The problem-based learning (PBL) is increasingly used in undergraduate education. However, the application of integrated PBL to medical undergraduate education has not been well assessed. An observational study was designed to compare integrated PBL combined with lecture-based classroom (LBC) with traditional LBC teaching in 2 semesters of a Medical School in China. This study was conducted from March 2021 to July 2022. A total of 118 undergraduates majoring in clinical medicine were randomly allocated in 2 groups, 1 group receiving the integrated PBL + LBC teaching (experimental group, n = 60) and another group receiving LBC teaching (control group, n = 58). The experimental group attended the integrated PBL courses for the basic and clinical medicine conducted in the 6th and 8th semesters, respectively, as well as taking the LBC courses. The experimental group was required to preview the course materials before class, make presentations in class and take online feedback questionnaires after class, while the control group was required to preview the textbooks and listen to the traditional LBC courses. The students' scores of these 2 groups were compared, and feedback questionnaires were performed to evaluate the effectiveness of the experimental group over the control group. Results showed that the experimental group scored significantly higher than the control group in Clinical Skills (95% confidence interval [CI] 4.19-5.89), Internal Medicine I (95% CI: 1.85-9.93), Internal Medicine II (95% CI: 8.07-15.90), Introduction to Surgery (95% CI: 5.08-10.25), Surgery (General Surgery) (95% CI: 7.82-12.72), Surgery (Specialty) (95% CI: 6.47-9.97), and Clinical Medical Level Test (95% CI: 1.60-5.15) (all P < .01). In the feedback questionnaires of integrated PBL, up to 80% and 90% of students were satisfied with the teaching methods and lecturers, respectively. More than 80% of students agreed that the integrated PBL improved their abilities to learn independently, understand knowledge, and to raise, analyze and solve problems. In terms of stress in and out of class, a small number of students, <36.7%, felt stressed. The integrated PBL combined with LBC is an effective teaching approach, which may provide new ideas for teaching research and reform on undergraduate medical education in clinical medicine specialty and other medical majors.
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Affiliation(s)
- He-Qin Zhan
- Department of Pathology, School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui, P.R. China
- Department of Pathology, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
| | - Xiao-Xun Zhang
- Department of Pathology, School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui, P.R. China
| | - Rong Qin
- Department of Pathology, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
| | - Jun Fei
- Department of Respiratory Internal Medicine, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
| | - Gui-Yin Dong
- Department of General Surgery, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
| | - Jia-Hu Hao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, P.R. China
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Santiago Fernandes Pimenta ID, de Sousa Mata ÁN, Machado Bezerra IN, Carneiro Capucho H, de Souza Oliveira AC, Echevarría Pérez P, Piuvezam G. Nontechnical skills training in intensive care units: Protocol for a systematic review and meta-analysis. PLoS One 2023; 18:e0280132. [PMID: 36607959 PMCID: PMC9821496 DOI: 10.1371/journal.pone.0280132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 12/21/2022] [Indexed: 01/07/2023] Open
Abstract
This study is aimed at describing a protocol for a systematic review and meta-analysis to assess the effect of nontechnical skills training on the acquisition of knowledge, skills or attitudes, and changes in behavior at the workplace, of healthcare professionals working in intensive care units (ICUs), as well as the effect on outcomes at an organizational level. We will search for original studies in the PubMed/Medline, Scopus, Web of Science, Science Direct, EMBASE and PsycINFO databases. Studies with a clinical trial or quasi-experimental design will be included. Two reviewers will independently screen and assess the included studies, with any disagreements being resolved by a third reviewer. We will summarize the findings using a narrative approach and, if possible, conduct a quantitative synthesis (meta-analysis). We will conduct the protocol following the Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols (PRISMA-P) guidelines. The review will summarize the current evidence on nontechnical skills training in ICUs, examining satisfaction with the training program, improvements in knowledge about nontechnical skills and the adoption of safety behaviors, as well as improvement in outcomes for the organization, such as mortality rates, length of stay and cost indicators. We expect that the systematic review could indicate effective strategies for training ICU professionals in nontechnical skills and also determine whether these strategies really improve the safety culture and professional knowledge and behaviors, as well as patient outcomes and safety.
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Affiliation(s)
| | - Ádala Nayana de Sousa Mata
- Multicampi School of Medical Sciences of Rio Grande do Norte, Federal University of Rio Grande do Norte, Caicó, Brazil
| | | | | | | | | | - Grasiela Piuvezam
- Post-Graduation Program in Public Health, Federal University of Rio Grande do Norte, Natal, Brazil
- Department of Public Health, Federal University of Rio Grande do Norte, Natal, Brazil
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Pereira FSH, Garcia DB, Ribeiro ER. Identifying patient safety competences among anesthesiology residents: systematic review. BRAZILIAN JOURNAL OF ANESTHESIOLOGY (ENGLISH EDITION) 2022; 72:657-665. [PMID: 35124107 PMCID: PMC9515668 DOI: 10.1016/j.bjane.2021.06.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 06/11/2021] [Accepted: 06/27/2021] [Indexed: 11/30/2022]
Abstract
Introduction and objective Patient safety is a concept of great importance to managers, health professionals, and patients and their families, given patient safety promotes more effective care and reduces costs. Moreover, while analyzing the area of anesthesiology, one can realize the epidemiological changes, increased complexity and number of procedures, and the adoption of a new matrix of essential skills mandatory for residents of anesthesiology in Brazil. Thus, it is relevant to identify current patient safety competences among anesthesiology residents. Methods A systematic review was elaborated using PubMed, SciELO, BVS, Cochrane Library, LILACS and CAPES databases with the descriptors “anesthesiology”, “patient safety”, “residency” and “competence”. Results and conclusions Thirteen articles published in the past 10 years were analyzed. The articles depicted competences grouped into three categories: knowledge (identification, prevention and management of adverse events; use of correct and up-to-date information; understanding of human factors; and continuous learning), skills (efficient communication; teamwork; leadership; decision-making; and self-confidence), and attitude (management of stress and fatigue; and infection control). All these skills can be developed and assessed through simulation and active learning methods, profiting from a multidisciplinary approach. Studies also reveal that residents perform poorly in certain patient safety domains due to lack of effective in-depth understanding, appreciation of the topic and ineffective teaching. As a result, greater investment in the topic is needed by teaching and health institutions and researchers.
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Fayed M, Nowak K, Angappan S, Patel N, Abdulkarim F, Penning DH, Chhina AK. Emergent Surgical Airway Skills: Time to Re-evaluate the Competencies. Cureus 2022; 14:e23260. [PMID: 35342673 PMCID: PMC8929234 DOI: 10.7759/cureus.23260] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction One of the most challenging scenarios an anesthesia provider can face is treating a can't intubate can't ventilate (CICV) patient. The incidence of CICV is estimated to be around one in 10,000 cases. According to the American Society of Anesthesiology Closed Claims Study, adverse respiratory events are the most common type of injury, with difficult intubation and ventilation contributing to the majority of these cases. The objective of this non-interventional quality improvement project was to evaluate the prior training, exposure, and self-reported confidence in handling the CICV scenario among anesthesia providers at Henry Ford Hospital in Detroit, MI. Methods An online questionnaire was distributed via email to all residents, certified registered nurse anesthetists (CRNAs), and attending anesthesiologists in March 2021. The email contained a link to an online questionnaire via Microsoft Forms (Microsoft Corporation, Redmond, WA). Univariate group comparisons were carried out between the respondents’ role (attending, CRNA, or resident), as well as between the number of years that the respondents were in practice (< 5 years, 5-10 years, > 10 years). Results Out of the total 170 anesthesia providers, 119 participated in the study where 54 (45%) were attendings, 44 (37%) were residents, and 21 (18%) were CRNAs. The majority (75%) did not know the surgical airway kit location, and 87% had not performed the surgical airway procedure before. The vast majority (96.7%) recommended simulation training compared to online training or lecture series, and just over 50% recommended annual training frequency. When looking at the differences in responses based on years of experience as an anesthesia provider, the majority of those with > 10 years in practice knew how to perform the surgical airway technique while respondents with < 5 years did not know how to perform the technique, and 50% of those with five to 10 years experience knew how to perform the surgical airway procedure for a CICV scenario. Conclusion Although there were many significant differences observed between the various provider roles and years in practice, surprisingly, the responses revealed both a lack of experience and confidence in performing the surgical airway procedure in all provider roles. These findings highlight a need for better emergency airway teaching and training. These findings will be used to guide the design and implementation of improved surgical airway training for residents, CRNAs, and attending anesthesiologists with the goal of better preparedness for handling a CICV scenario.
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Affiliation(s)
- Mohamed Fayed
- Anesthesiology, Pain Management and Perioperative Medicine, Henry Ford Health System, Detroit, USA
| | | | - Santhalakshmi Angappan
- Anesthesiology, Pain Management and Perioperative Medicine, Henry Ford Health System, Detroit, USA
| | - Nimesh Patel
- Anesthesiology, Pain Management and Perioperative Medicine, Henry Ford Health System, Detroit, USA
| | - Fawaz Abdulkarim
- Anesthesiology, Pain Management and Perioperative Medicine, Henry Ford Health System, Detroit, USA
| | - Donald H Penning
- Anesthesiology, Pain Management and Perioperative Medicine, Henry Ford Health System, Detroit, USA
| | - Anoop K Chhina
- Anesthesiology, Pain Management and Perioperative Medicine, Henry Ford Health System, Detroit, USA
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Kazior MR, Chen F, Isaak R, Dhandha V, Cobb KW. Perception Precedes Reality: A Simulation and Procedural Bootcamp Improves Residents’ Comfort With Transitioning to Clinical Anesthesiology Training. Cureus 2022; 14:e21706. [PMID: 35242473 PMCID: PMC8883744 DOI: 10.7759/cureus.21706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2022] [Indexed: 11/15/2022] Open
Abstract
Background The transition from internship to clinical anesthesiology (CA) training is often difficult given the differences in workflow, procedures, environment, and clinical situations. The primary aims of this study were to determine if a standardized introductory bootcamp could improve clinical knowledge and self-perceived comfort level of new anesthesiology residents in performing common operating room procedures and management of common intraoperative problems. The secondary aim of the study was to see if a standardized bootcamp could be replicated at other programs. Methods The introduction to anesthesiology resident bootcamp was developed at one institution in 2015 then expanded to a second program in 2019. The bootcamp was a one-day experience consisting of simulation and task trainers that all rising first-year CA residents (CA-1) participated in during their first month of anesthesiology training. All participating residents were given a survey immediately before and after the bootcamp. The average ratings of the questions were calculated and used as the primary measure. The Anesthesia Knowledge Test (AKT) was used as a surrogate measure of participant knowledge. Results From 2015 to 2020, a total of 105 residents completed the pre-survey and 109 completed the post-survey across the two sites. The improvement in average rating was significant (Pre: 2.04±0.46 versus Post: 3.09±0.52 p<0.0001). Individual item analysis also showed significant improvement on all of the eight items (p<0.0001). Analyses by site revealed the same results at both average score and item level. There was no significant cohort difference in either AKT-0 (Control: 57.84±26.86 versus Intervention 50.13±25.14, p=0.14) or AKT-1 (Control: 41.06±26.42 versus Intervention 41.70±26.60, p=0.90) percentile scores. Conclusions Incorporation of an introduction to anesthesia bootcamp for new residents significantly improves participant comfort level and is reproducible across institutions. However, it does not improve resident performance on standardized tests.
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