Anesthesiology clinics
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Anesthesiology clinics · Sep 2007
Perioperative care of patients with neuromuscular disease and dysfunction.
A variety of different pathologies result in disease phenotypes that are summarized as neuromuscular diseases because they share commonalty in their clinical consequences for the patient: a progressive weakening of the skeletal muscles. Distinct caution and appropriate changes to the anesthetic plan are advised when care is provided during the perioperative period. The choice of anesthetic technique, anesthetic drugs, and neuromuscular blockade always depends on the type of neuromuscular disease and the surgical procedure planned. A clear diagnosis of the underlying disease and sufficient knowledge and understanding of the pathophysiology are of paramount importance to the practitioner and guide optimal perioperative management of affected patients.
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Anesthesiology clinics · Jun 2007
ReviewAnesthesiology national CME program and ASA activities in simulation.
This article traces the history of anesthesiology's role in simulation from Resusci Anne and Sim One to the use of simulation today for introducing new products and techniques to otherwise fully trained, practicing physicians. The article also describes the latest efforts of the American Society of Anesthesiologists (ASA) to promote simulation-based instruction. ⋯ Many predict that simulation-based teaching will generate the next revolution in health care education. The ASA is hoping to capitalize on anesthesiology's long involvement and leadership in simulation-based health care education to help bring about this revolution.
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Assessment and evaluation are integral parts of any educational and training process, and students at all levels of training respond by studying more seriously for the parts of the course or training that are assessed. To promote and enhance effective learning successfully, simulation and other teaching methods should be both formative and summative, because the ultimate goal is to ensure professional competence. This article describes a model of medical competence, and focuses on the use of medical simulation in assessment and evaluation of different levels of clinical competence using examples from experience.
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This article reviews medical team training using the principles of crew resource management (CRM). It also briefly discusses crisis resource management, a subset of CRM, as applied to high-acuity medical situations. ⋯ Team training programs are classified and examples of simulation-based and classroom-based programs are offered and their merits discussed. Finally, a brief look at the future of team training concludes this review article.
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Traditional medical education has emphasized autonomy, and until recently issues related to teamwork have not been explicitly included in medical curriculum. The Institute of Medicine highlighted that health care providers train as individuals, yet function as teams, creating a gap between training and reality and called for the use of medical simulation to improve teamwork. The aviation industry created a program called Cockpit and later Crew Resource Management that has served as a model for team training programs in medicine. This article reviews important concepts related to teamwork and discusses examples where simulation either could be or has been used to improve teamwork in medical disciplines to enhance patient safety.