PDF(Pubmed)
Abstract：
BACKGROUND: Learning in the operating room (OR) for residents in anesthesiology is difficult but essential for successful resident education. Numerous approaches have been attempted in the past to varying degrees of success, with efficacy often judged afterward using surveys distributed to participants. The OR presents a particularly complex set of challenges for academic faculty due to the pressures required by concurrent patient care, production pressures, and a noisy environment. Often, educational reviews in ORs are personnel specific, and instruction may or may not take place in this setting, as it is left to the discretion of the parties without regular direction.
OBJECTIVE: This study aims to determine if a structured intraoperative keyword training program could be used to implement a curriculum to improve teaching in the OR and to facilitate impactful discussion between residents and faculty. A structured curriculum was chosen to allow for the standardization of the educational material to be studied and reviewed by faculty and trainees. Given the reality that educational reviews in the OR tend to be personnel specific and are often focused on the clinical cases of the day, this initiative sought to increase both the time and efficiency of learning interactions between learners and teachers in the stressful environment of the OR.
METHODS: The American Board of Anesthesiology keywords from the Open Anesthesia website were used to construct a weekly intraoperative didactic curriculum, which was distributed by email to all residents and faculty. A weekly worksheet from this curriculum included 5 keywords with associated questions for discussion. The residents and faculty were instructed to complete these questions on a weekly basis. After 2 years, an electronic survey was distributed to the residents to evaluate the efficacy of the keyword program.
RESULTS: A total of 19 teaching descriptors were polled for participants prior to and following the use of the intraoperative keyword program to assess the efficacy of the structured curriculum. The survey results showed no improvement in intraoperative teaching based on respondent perception, despite a slight improvement in teaching time, though this was statistically insignificant. The respondents reported some favorable aspects of the program, including the use of a set curriculum, suggesting that greater structure may be beneficial to facilitate more effective intraoperative teaching in anesthesiology.
CONCLUSIONS: Although learning is difficult in the OR for residents, the use of a formalized didactic curriculum, centered on daily keywords, does not appear to be a useful solution for residents and faculty. Further efforts are required to improve intraoperative teaching, which is well known to be a difficult endeavor for both teachers and trainees. A structured curriculum may be used to augment other educational modalities to improve the overall intraoperative teaching for anesthesia residents.
OBJECTIVE: This study aims to determine if a structured intraoperative keyword training program could be used to implement a curriculum to improve teaching in the OR and to facilitate impactful discussion between residents and faculty. A structured curriculum was chosen to allow for the standardization of the educational material to be studied and reviewed by faculty and trainees. Given the reality that educational reviews in the OR tend to be personnel specific and are often focused on the clinical cases of the day, this initiative sought to increase both the time and efficiency of learning interactions between learners and teachers in the stressful environment of the OR.
METHODS: The American Board of Anesthesiology keywords from the Open Anesthesia website were used to construct a weekly intraoperative didactic curriculum, which was distributed by email to all residents and faculty. A weekly worksheet from this curriculum included 5 keywords with associated questions for discussion. The residents and faculty were instructed to complete these questions on a weekly basis. After 2 years, an electronic survey was distributed to the residents to evaluate the efficacy of the keyword program.
RESULTS: A total of 19 teaching descriptors were polled for participants prior to and following the use of the intraoperative keyword program to assess the efficacy of the structured curriculum. The survey results showed no improvement in intraoperative teaching based on respondent perception, despite a slight improvement in teaching time, though this was statistically insignificant. The respondents reported some favorable aspects of the program, including the use of a set curriculum, suggesting that greater structure may be beneficial to facilitate more effective intraoperative teaching in anesthesiology.
CONCLUSIONS: Although learning is difficult in the OR for residents, the use of a formalized didactic curriculum, centered on daily keywords, does not appear to be a useful solution for residents and faculty. Further efforts are required to improve intraoperative teaching, which is well known to be a difficult endeavor for both teachers and trainees. A structured curriculum may be used to augment other educational modalities to improve the overall intraoperative teaching for anesthesia residents.
摘要：
背景：在手术室（OR）中学习麻醉学是很困难的，但对于成功的住院医师教育至关重要。过去已经尝试了许多方法，取得了不同程度的成功，随后通常使用分发给参与者的调查来判断疗效。由于并发患者护理所需的压力，OR为学术教师带来了一系列特别复杂的挑战，生产压力，和嘈杂的环境。通常,OR中的教育评论是针对人员的，和指令可能会或可能不会发生在这个设置，因为它是留给各方的自由裁量权，没有正常的指示。
目的：本研究旨在确定结构化术中关键词培训计划是否可用于实施课程，以改善手术室的教学，并促进居民和教师之间有影响力的讨论。选择了结构化的课程，以允许教师和受训者对教材进行标准化研究和审查。鉴于OR中的教育审查往往是针对人员的，并且通常侧重于当天的临床病例，该计划旨在增加在OR压力环境中学习者和教师之间学习互动的时间和效率。
方法：来自开放麻醉网站的美国麻醉学委员会关键词用于构建每周的术中教学课程，通过电子邮件分发给所有居民和教职员工。本课程的每周工作表包括5个关键字，以及相关的讨论问题。指示居民和教职员工每周完成这些问题。两年后,向居民分发了一份电子调查，以评估关键字程序的有效性。
结果：在使用术中关键词计划评估结构化课程的有效性之前和之后，共对参与者进行了19项教学描述的调查。调查结果显示，基于受访者感知的术中教学没有改善，尽管教学时间略有改善，尽管这在统计上微不足道。受访者报告了该计划的一些有利方面，包括使用一套课程，这表明更大的结构可能有利于促进麻醉中更有效的术中教学。
结论：尽管居民在手术室学习很困难，使用形式化的教学课程，以每日关键词为中心，对居民和教师来说似乎不是一个有用的解决方案。需要进一步努力改善术中教学，众所周知，这对教师和受训者来说都是一项艰巨的任务。结构化课程可用于增强其他教育方式，以改善麻醉住院医师的整体术中教学。
目的：本研究旨在确定结构化术中关键词培训计划是否可用于实施课程，以改善手术室的教学，并促进居民和教师之间有影响力的讨论。选择了结构化的课程，以允许教师和受训者对教材进行标准化研究和审查。鉴于OR中的教育审查往往是针对人员的，并且通常侧重于当天的临床病例，该计划旨在增加在OR压力环境中学习者和教师之间学习互动的时间和效率。
方法：来自开放麻醉网站的美国麻醉学委员会关键词用于构建每周的术中教学课程，通过电子邮件分发给所有居民和教职员工。本课程的每周工作表包括5个关键字，以及相关的讨论问题。指示居民和教职员工每周完成这些问题。两年后,向居民分发了一份电子调查，以评估关键字程序的有效性。
结果：在使用术中关键词计划评估结构化课程的有效性之前和之后，共对参与者进行了19项教学描述的调查。调查结果显示，基于受访者感知的术中教学没有改善，尽管教学时间略有改善，尽管这在统计上微不足道。受访者报告了该计划的一些有利方面，包括使用一套课程，这表明更大的结构可能有利于促进麻醉中更有效的术中教学。
结论：尽管居民在手术室学习很困难，使用形式化的教学课程，以每日关键词为中心，对居民和教师来说似乎不是一个有用的解决方案。需要进一步努力改善术中教学，众所周知，这对教师和受训者来说都是一项艰巨的任务。结构化课程可用于增强其他教育方式，以改善麻醉住院医师的整体术中教学。
