Anesthesiology
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Most studies examining the prognostic value of preoperative coagulation testing are too small to examine the predictive value of routine preoperative coagulation testing in patients having noncardiac surgery. ⋯ Platelet count abnormalities found in the course of routine preoperative screening are associated with a higher risk of blood transfusion and death.
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Clinical teachers and trainees share a common view of what constitutes excellent clinical teaching, but associations between these behaviors and high teaching scores have not been established. This study used residents' written feedback to their clinical teachers, to identify themes associated with above- or below-average teaching scores. ⋯ The authors developed 13 recommendations for clinical teachers using the themes identified from the above- and below-average clinical teaching evaluations submitted by anesthesia residents.
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Effective teamwork is important for patient safety, and verbal communication underpins many dimensions of teamwork. The validity of the simulated environment would be supported if it elicited similar verbal communications to the real setting. The authors hypothesized that anesthesiologists would exhibit similar verbal communication patterns in routine operating room (OR) cases and routine simulated cases. The authors further hypothesized that anesthesiologists would exhibit different communication patterns in routine cases (real or simulated) and simulated cases involving a crisis. ⋯ The similarity of teamwork-related communications elicited from anesthesiologists in simulated cases and the real setting lends support for the ecological validity of the simulation environment and its value in teamwork training. Different communication patterns and frequencies under the challenge of a crisis support the use of simulation to assess crisis management skills.
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Historical Article
Competency-based Education in Anesthesiology: History and Challenges.
The Accreditation Council for Graduate Medical Education is transitioning to a competency-based system with milestones to measure progress and define success of residents. The confines of the time-based residency will be relaxed. Curriculum must be redesigned and assessments will need to be precise and in-depth. ⋯ Innovative new educational opportunities will need to be created for fast learners. Finally, it will be important that residents embrace this change. This will require programs to clearly define the specific aims and measurement endpoints for advancement and success.