• Franklin Dexter, Ilana I Logvinov, and Sorin J Brull.
• Division of Management Consulting, Department of Anesthesia, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA. Franklin-Dexter@UIowa.edu
• Anesth. Analg.. 2013 Jun 1;116(6):1352-5.

BackgroundOften anesthesia care is provided by nonfaculty anesthesia providers (e.g., anesthesiology residents and certified registered nurse anesthetists [CRNAs]) under the guidance of faculty anesthesiologists. Performance appraisal of faculty anesthesiologists should therefore include evaluation of this guidance.MethodsResidents and CRNAs from 3 teaching hospitals gave their "impression of 9 attributes of the hypothetical supervising anesthesiologist who meets … expectations … not … who exceeds expectations or whose activity is below … expectations." Scores were based on the anesthesiologist working with the respondent, not others. A 4-point scale (e.g., 1 = never, 2 = rarely, 3 = frequently, and 4 = always) was used, and the mean was calculated.ResultsThe participation rate was 51% among CRNAs (N = 153) and 58% among resident physicians (N = 47). There was no association between years since the start of training and supervision scores that met expectations among CRNAs (Kendall τb = 0.01; 95% confidence interval [CI], -0.13 to +0.10; P = 0.90) or residents (τb = 0.03; 95% CI, -0.16 to +0.23; P = 0.77). Most CRNAs (67%) and residents (94%) perceived that supervision that met their expectations was at least "frequent" (score ≥3.0) (both P < 0.0001). The mean ± SD of supervision scores that met expectations was 3.14 ± 0.42 for CRNAs versus 3.40 ± 0.30 for residents. The CRNAs' score mean was 0.26 less than that of residents (P < 0.0001; 95% CI, 0.15 to 0.37 less). There were 30% of CRNAs with scores larger than the residents' mean.ConclusionsMost CRNAs and residents at 3 teaching hospitals considered faculty guidance that meets expectations to be at least "frequent," regardless of years in practice.

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