Anesthesiologists' perception on their residency training

Background

Self-regulated professions such as medicine are characterized by professional commitment to the public they serve and require life-long development of expected skills. There is a paucity of data regarding quality of training during residency in anesthesiology. The objective of this study was to create an instrument to assess the anesthesiologists’ perception regarding the quality of their training during medical residency.

Methods

An electronic questionnaire was sent to 120 anesthesiologists, assuming 15% response rate for worst case scenario, considering a number of 613 potential respondents. The answers to the questionnaire were submitted to psychometric evaluation through internal consistency analysis measured by the Cronbach’s alpha coefficient, and factorial analysis by the principal components’ method with varimax rotation method with Kaiser normalization. The level of Concordance (C) and Disaccord (D) of each item were compared byz tests (consensus if p < 0.05). A question asking the respondents if they would recommend their training center to a relative or a friend was added to the questionnaire and considered as a secondary outcome.

Results

One hundred and one responses were obtained. The Cronbach’s alpha value was 0.86, suggesting good reliability of the questionnaire. The initial analysis including all the 14 items presented on the questionnaire demonstrated that four components obeyed the Kaiser criterion, depicting 68.20% of variance. Consensus was achieved among participants regarding all items of the questionnaire. The medical residency in anesthesiology was recommended by 93% of the participants. Preceptors were considered role-models by 83% of the participants. Acquisition of practical skills was better evaluated in comparison to other areas.

Conclusion

The questionnaire effectively characterized the perception of anesthesiologists regarding the quality of their training during medical residency. The information produced by this instrument could provide interesting clues on the quality of residency programs, pointing out areas of education that need more attention.

Risk factors for postoperative pulmonary complications and prolonged hospital stay in pulmonary resection patients: a retrospective study

Background

Postoperative pulmonary complications are the main cause of morbidity and mortality after pulmonary resection. This study was undertaken to determine the risk factors associated with postoperative pulmonary complications (PPCs) and length of hospital stay (LOS) in pulmonary resection patients in a tertiary teaching hospital in Brazil.

Methods

A retrospective data gathering from 196 patients who underwent pulmonary resection between 2012 and 2016 was conducted. Demographic and hospital admission data were collected from patients with complete medical records. Univariate analysis was performed, followed by Poisson’s regression for predicting the prevalence of postoperative pulmonary complications and length of hospital stay.

Results

Thirty-nine patients (20%) displayed pulmonary complications in the postoperative period. The risk factors associated with an increased prevalence of postoperative pulmonary complications in a multivariate analysis were: American Society of Anesthesiologists physical status (ASA) ≥ 3 (PR 4.77, p = 0.03, 95% CI: 1.17 to 19.46), predicted diffusion capacity of the lungs for carbon monoxide – corrected single breath (PR 0.98, p < 0.001, 95% CI: 0.96 to 0.99) and age of the patient (PR 1.04; p = 0.01; 95% CI: 1.01 to 1.06). Those associated with an increased prevalence of prolonged hospital stay were: duration of surgical procedure longer than five hours (PR 6.94, p = 0.01, 95% CI: 1.66 to 12.23), male sex (PR 5.72, p < 0.001, 95% CI: 1.87 to 9.58), and presence of postoperative pulmonary complications (PR 11.92, p < 0.001, 95% CI: 7.42 to 16.42).

Conclusions

The rate of postoperative pulmonary complications in the study population is in line with the world average. Recognizing risk factors for the development of PPCs may help optimize allocation resources and preventive efforts.