anesthesia education

  • 文章类型: Journal Article
    目的:描述针对麻醉居民的基于原位模拟的综合课程的开发和实施。
    方法:这是一项前瞻性研究。
    方法:本研究在一所大学医院进行。
    方法:这项单中心前瞻性研究纳入了参加麻醉住院医师计划的所有53名麻醉住院医师。
    方法:介绍例行程序,高保真,现场模拟程序,包括短期会议,以培训居民在必要的技能和决策过程所需的手术室。
    结果:我们的团队在正常工作时间内进行了182次单独的15分钟模拟会议,为期3个月。我们计划中的所有53名居民都积极参与了模拟。大多数居民至少参加3次会议,每位居民的平均参与率为3.4(范围,1-6届会议)。居民完成了在线匿名调查,在3个月期间,回应率为71.7%(53名居民中的38名)。调查旨在评估他们对该项目的总体印象和感知对培训的贡献。
    结论:我们提出的教学方法可以弥合住院医师培训的差距,并增强他们的批判性推理,以管理他们在住院期间可能没有经历的各种临床情况。
    OBJECTIVE: To describe the development and implementation of a comprehensive in situ simulation-based curriculum for anesthesia residents.
    METHODS: This is a prospective study.
    METHODS: This study was conducted at a university hospital.
    METHODS: This single-center prospective study included all 53 anesthesia residents enrolled in the anesthesia residency program.
    METHODS: Introduction of a routine, high-fidelity, in situ simulation program that incorporates short sessions to train residents in the necessary skill sets and decision-making processes required in the operating room.
    RESULTS: Our team conducted 182 individual 15-minute simulation sessions over 3 months during regular working hours. All 53 residents in our program actively participated in the simulations. Most residents engaged in at least 3 sessions, with an average participation rate of 3.4 per resident (range, 1-6 sessions). Residents completed an online anonymous survey, with a response rate of 71.7% (38 of 53 residents) over the 3-month period. The survey aimed to assess their overall impression and perceived contribution of this project to their training.
    CONCLUSIONS: Our proposed teaching method can bridge the gap in resident training and enhance their critical reasoning to manage diverse clinical situations they may not experience during their residency.
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  • 文章类型: Journal Article
    教师发展很重要,但往往受到与持续责任冲突的限制。俄勒冈健康与科学大学麻醉与围手术期医学系安排更多的教职员工在周三工作,早上的非临床时间和下午的临床任务,以方便住院医师学习半天(AHD)。我们设计了一种新颖的教师发展课程,该课程使用Kern的6步课程开发方法在AHD的早晨运行,并假设它是可行且令人满意的。
    进行了需求评估。两位医学教育专家制定了课程,并寻求接受医学教育培训的教师来领导会议。五名参与者完成了干预前,每日会议,以及干预后的调查。满意度通过调查进行评估。通过会议出席和调查评估了可行性。使用柯克帕特里克的程序评估模型,并进行了专题分析。
    所有参与者回答“强烈同意”所有参与者满意的干预后问题。所有参与者都能够达到>50%的出勤率目标,仅在预呼叫时丢失会话,通话后,在假期,或生病。所有参与者都报告了行为的变化,并报告了他们的临床医师教育者职业身份的发展。一名参与者报告说,他们重申了对学术医学的承诺。
    在工作时间提供的这种教师发展试点课程是可行的,参与者非常满意。此外,主题分析表明,该课程帮助教师培养了临床医生教育者的职业身份,并改变了他们的行为。未来的工作将包括定性研究,以了解对参与者行为和职业身份形成的影响。
    UNASSIGNED: Faculty development is important but often limited by conflict with ongoing responsibilities. The Oregon Health & Science University Department of Anesthesiology & Perioperative Medicine schedules more faculty physicians to work on Wednesdays, with nonclinical time in the morning and a clinical assignment in the afternoon, to facilitate a resident physician academic half-day (AHD). We designed a novel faculty development course to run in the mornings of the AHD using Kern\'s 6-step approach to curriculum development and hypothesized that it would be feasible and satisfactory.
    UNASSIGNED: A needs assessment was performed. Two experts in medical education developed the curriculum and sought faculty with medical education training to lead sessions. Five participants completed pre-intervention, daily session, and post-intervention surveys. Satisfaction was evaluated by surveys. Feasibility was evaluated by session attendance and surveys. Kirkpatrick\'s model for program evaluation was used, and a thematic analysis was performed.
    UNASSIGNED: All participants responded \"Strongly Agree\" to all participant satisfaction post-intervention questions. All participants were able to meet the >50% attendance goal, only missing sessions when pre-call, post-call, on vacation, or ill. All participants reported changes in behavior and reported developing their clinician educator professional identities. One participant reported re-affirming their commitment to academic medicine.
    UNASSIGNED: This faculty development pilot course provided during work hours was feasible, and participants were highly satisfied. In addition, thematic analysis suggests that the course helped faculty develop a clinician educator professional identity and changed their behavior. Future work will include a qualitative study to understand the impact on participant behavior and professional identity formation.
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  • 文章类型: Journal Article
    估计有17亿儿童和青少年无法获得安全和负担得起的手术护理,其中绝大多数位于中低收入国家(LMICs)。儿科麻醉,一个需要不同知识和技能的专业领域,多年来取得了各种进步,并在中高收入国家得到了很好的发展。然而,在LMICs中,由于多种因素,包括严重的劳动力短缺,情况并非如此。合作在提高儿科麻醉教育者的能力和培训儿科麻醉人员方面起着至关重要的作用。这些努力直接增加了需要手术干预的儿童的机会。协作模型可以通过双向知识共享来操作,培训,资源分配,研究与创新,质量改进,网络,和宣传。本文旨在强调其中的一些合作努力。具体来说,世界麻醉师协会联合会的作用,更安全的麻醉教育计划,亚洲小儿麻醉师学会,非洲的小儿麻醉培训,新西兰儿科麻醉网络,安全儿科麻醉网络和两个WhatsApp™小组(全球麻醉和儿科困难插管协作)在改善儿童麻醉护理方面发挥了作用。
    An estimated 1.7 billion children and adolescents do not have access to safe and affordable surgical care, and the vast majority of these are located in low-middle-income countries (LMICs). Pediatric anesthesia, a specialized field that requires a diverse set of knowledge and skills, has seen various advancements over the years and has become well-established in upper-middle and high-income countries. However, in LMICs, due to a multitude of factors including severe workforce shortages, this has not been the case. Collaborations play a vital role in increasing the capacity of pediatric anesthesiology educators and training the pediatric anesthesia workforce. These efforts directly increase access for children who require surgical intervention. Collaboration models can be operationalized through bidirectional knowledge sharing, training, resource allocation, research and innovation, quality improvement, networking, and advocacy. This article aims to highlight a few of these collaborative efforts. Specifically, the role that the World Federation of Societies of Anaesthesiologists, the Safer Anesthesia from Education program, the Asian Society of Pediatric Anaesthesiologists, Pediatric Anesthesia Training in Africa, the Paediatric Anaesthesia Network New Zealand, the Safe Pediatric Anesthesia Network and two WhatsApp™ groups (global ped anesthesia and the Pediatric Difficult Intubation Collaborative) have played in improving anesthesiology care for children.
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  • 文章类型: Journal Article
    目的:本研究旨在微调大型语言模型(LLM),用于外科和麻醉住院医师教育中特定领域的文本生成。
    背景:随着人们对人工智能(AI)进行医疗培训的兴趣与日俱增,探索了法学硕士改造住院医师教育的潜力。
    方法:70亿个参数基础模型“Vicunav1.5”在821个同行评审文件的266,342行文本上进行了训练。我们用150次手术或麻醉查询评估了模型,并评估了准确性,令牌计数,和各种推理任务的推理速度。使用ANOVA和卡方分析进行显著性检验。
    结果:我们的模型达到了65.3%的准确率,擅长以外科病例为基础的任务。我们发现知识领域之间的准确性没有显着差异(P=0.081),尽管更长的响应生成显示出更低的准确性,基于输出长度的精度变化显著(P​=0.002)。
    结论:LLM显示出增强住院医师教育的潜力。我们的模型的效率和特定于任务的准确性突出了这样的承诺,尽管参数计数的限制会降低更长响应生成的准确性。我们的研究结果展示了人工智能如何有效地整合到未来的住院医师培训中。
    OBJECTIVE: This study aimed to fine-tune a large language model (LLM) for domain-specific text generation in surgical and anesthesia residency education.
    BACKGROUND: With growing interest in artificial intelligence (AI) for medical training, the potential of LLMs to transform residency education is explored.
    METHODS: The 7-billion parameter base model \"Vicuna v1.5\" was trained on 266,342 lines of text from 821 peer-reviewed documents. We evaluated the model with 150 surgical or anesthesia queries and assessed accuracy, token count, and inference speed across various reasoning tasks. Tests of significance were conducted using ANOVA and chi-square analysis.
    RESULTS: Our model achieved 65.3% accuracy, excelling in surgical case-based tasks. We found no significant difference in accuracy between knowledge domains (P=0.081), though longer response generation demonstrated poorer accuracy, with significant accuracy variation based on output length (P ​= ​0.002).
    CONCLUSIONS: LLMs show potential in enhancing residency education. Our model\'s efficiency and task-specific accuracy highlights such promise, though limits in parameter count diminishes accuracy of longer response generation. Our findings showcase how AI may be integrated effectively within future residency training.
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  • 文章类型: Journal Article
    OBJECTIVE: COVID-19 prevention and control demand a reduction in crowd gathering, which has a significant impact on traditional teaching and offline case-based learning (CBL). In order to mitigate the impact of the COVID-19 outbreak on clinical teaching, we aimed to compare the effects of an online CBL with traditional teaching model on learning outcomes of anesthesia residents.
    METHODS: Residents rotated in the Department of Anesthesiology in Beijing Tsinghua Changgung Hospital from January 2020 to February 2021 were included in Group W (n = 19), which implemented the W-CBL teaching model. The performance of residents was evaluated with theory test and 2 survey questionnaires (A and B) were conducted after 1 month of rotating. All 20 residents rotating in the Department of Anesthesiology at our hospital from January 2018 to December 2019 were included in Group C, which implemented the traditional teaching model. Their examination results were acquired through the teaching files and survey questionnaire (A) were administered through WeChat.
    RESULTS: During the 1-month rotation, a total of 10 cases were discussed in Group W. The average score for theory test was higher in Group W than that in Group C (84.57 ± 4.87 vs. 79.35 ± 3.70, P = 0.001). The satisfaction rate was also in favor of Group W regarding to clinical thinking, communication skills, learning interest and self-learning ability (P < 0.05).
    CONCLUSIONS: Online CBL based on WeChat platform is an effective and acceptable teaching strategy in comparison to lecture-based learning (LBL) among residents embarking on clinical anesthesia courses.
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  • 文章类型: Journal Article
    The COVID-19 pandemic has forced organizers of traditional in-person continuing medical education conferences to transition to a virtual format. There are both advantages and disadvantages to this change in format. When planning a virtual meeting, several factors require consideration, including costs, virtual platforms, sponsorship, networking, and meeting logistics. This manuscript describes the authors\' experiences of transforming the Society of Education in Anesthesia 2020 Fall Meeting into a virtual conference and explores the lessons learned and future impacts of this new medium.
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  • 文章类型: Journal Article
    OBJECTIVE: Physician burnout is a pervasive problem in the United States. The goal of this study was to investigate use of the smartphone meditation application Headspace® as a well-being improvement tool in anesthesia trainees.
    METHODS: Prospective self-controlled observational study.
    METHODS: Anesthesia training program in an academic hospital.
    METHODS: Resident and fellow trainees in the Department of Anesthesiology and Perioperative Medicine at the University of Pittsburgh Medical Center.
    METHODS: Resident and fellow trainees were given a free 1-year subscription to the mindfulness application. Participation was voluntary and included questionnaires at baseline, 1 month, and 4 months for assessment of burnout and well-being. Questionnaires were linked with the use of de-identified codes and completed via REDCap. Questionnaires included the abbreviated Maslach Burnout Inventory, Becks Depression Index, Cohens Stress Score, Pittsburgh Sleep Quality Index, and a Headspace® Self-Reporting Questionnaire.
    METHODS: Depression, stress, sleep quality, emotional exhaustion, depersonalization, and personal achievement.
    RESULTS: Of 112 trainees eligible to participate, 71 completed baseline questionnaires, 54 created application accounts, and 29 completed the entire questionnaire protocol with 4 months of app use. Application use was associated with reduced depression scores and increased feelings of personal achievement at both 1 month (p = 0.003, p = 0.066) and 4 months (p = 0.011, p = 0.005). Burnout from feelings of depersonalization and emotional exhaustion did not improve with application use. Over the study period, trainees completed 786 meditation sessions, accounting for 6123 min of app engagement.
    CONCLUSIONS: Findings of decreased depression scores and improved feelings of personal achievement suggest that Headspace® could serve as a mindfulness tool for incorporating meditation into the daily practice of anesthesia trainees in an effort to improve well-being.
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  • 文章类型: Journal Article
    UNASSIGNED: Reform in medical education is a basic process in every academic department, especially in residency programs.
    UNASSIGNED: This study was designed to assess the indices of education and research as part of the Medical Education Reform program (MERP) in the Department of Anesthesiology and Critical Care (DACC), Shahid Beheshti University of Medical Sciences (SBMU) for four years.
    UNASSIGNED: MERP in DACC, SBMU was designed and implemented as a modern academic reform model; different outcome measures in education and research were assessed to demonstrate the effects of the reform plan in academic improvements.
    UNASSIGNED: there were significant improvements regarding education indices (i.e., teaching methods, passing comprehensive exams, mentorship, assessment methods, faculty development, professionalism in medical education, integration in education, and crisis management) and research indices (targeted research activities, innovation in research approaches, increasing the impact of research).
    UNASSIGNED: Based on the experiences of DACC, SBMU regarding clinical anesthesiology residency, reform could be achieved using painstaking plans and continuous efforts with tangible documented outcomes. Often, the management period is not durable, and these reforms require meticulous care to sustain.
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  • 文章类型: Journal Article
    Brief description of the primary research objective Among healthcare workers, anesthesiologists are regarded as frequently exposed frontline providers in the fight against COVID-19 due to their proximity to patient airways and involvement in aerosolized procedures. As such, the risk of contracting the COVID-19 virus as an occupational hazard is presumed to be higher. To date, in most published studies, all healthcare workers were grouped together, independent of specialty or profession. At the time that this survey was distributed, we did not find any peer-reviewed articles that differentiated COVID-19 infection rates among frontline, such as anesthesiologists vs. non-frontline healthcare workers. This retrospective survey\'s primary research objective was to report the rate of COVID-19 infection among anesthesiologists compared to the general population of healthcare workers. Methodology A survey was sent among anesthesiology attendings and residents in Northern New Jersey and Brooklyn, New York hospitals on duty during the peak pandemic from March 2020 to May 2020. Questions in the survey focused on infection rates and adherence to standards of infection precaution and personal protective equipment (PPE) utilization. Main Findings This retrospective study highlights the rate of infection among anesthesiologists as a particularly vulnerable subgroup of frontline residents and physicians, as they are called to duty when emergent airway management is required. In our study, the reported rate of contracting COVID-19 among anesthesiologists was 16.7%. This statistic is higher than the infection rates published by studies by New York State and the CDC. Conclusion The survey sent to anesthesiologists is useful to understand the impact of COVID-19 on this subgroup of frontline providers and the importance of adhering to standards of infection protocol and the role of PPE.
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  • 文章类型: Journal Article
    BACKGROUND: The goal of this study was to evaluate the impact of intubation skill training involving the use of mannequins on novice anesthesiology residents in a knowledge, attitudes, and practices designed study in which three different types of evaluation were implemented.
    METHODS: All first-year anesthesiology residents (24) of Sina Hospital, affiliated to the Tehran University of Medical Sciences, were invited to participate in an intubating skills training course. The program comprised two theoretical and three practical sessions, lasting a total of 16 hours over four days. Faculty assessment of residents\' practices was carried out using the questionnaire results, measured using a Likert scale, as the primary outcome. An improvement in the theoretical knowledge of the novice anesthesiology residents (using the Likert scale) and their attitudes towards the educational course in general (via a multiple choice question examination), were also evaluated.
    RESULTS: The mean score following faculty assessment of the residents\' practical skills was 4.6 out of 5.0 (92%) [standard deviation (SD) of 0.13]. The mean score with respect to the attitudes of the residents was 4.8 out of 5.0 (96%) (SD of 0.16). The overall mean theoretical score of the residents improved significantly upon completion of the training program (P = 0.001).
    CONCLUSIONS: Our results suggest that the personnel in the five participating faculties were highly satisfied with the practical performance of the residents, who were found to hold good attitudes towards the program as a whole.
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