Best practice & research. Clinical anaesthesiology
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Education is a core activity of academic departments but pressure from universities to maximize research income and research productivity, and from hospitals to deliver a more efficient clinical service, has pushed the importance of education into third place in many departments. Academic departments of anaesthesia can make significant contributions to undergraduate teaching. Students appreciate the one-to-one teaching which they receive from anaesthetists and the range of practical skills which they can learn. ⋯ Teaching methods are changing, and there are opportunities to exploit e-learning on Intranet sites, and anaesthesia simulators, in both undergraduate and postgraduate education. Clinical governance issues and increasing scrutiny by authorities which fund teaching or set professional standards have resulted in demands for evidence that educational objectives are being met and that assessment systems are robust. There is a recognition that education has a cost, and resources are available from universities and hospitals to support the teaching activities of academic departments of anaesthesia.
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Best Pract Res Clin Anaesthesiol · Sep 2002
Anaesthetic team and the role of nurses--North American perspective.
Anaesthesia is an American invention but the development of anaesthesia practice took two paths at its inception. The American-based ether anaesthetic technique allowed for non-physician personnel to administer the drug. ⋯ This article discusses the historical events leading to the development of nurse anaesthesia practice in the USA. The current status of physician and nurse anaesthetist interactions--both harmonious and acrimonious--are presented.
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The distribution of anaesthesia-related staff in Europe is characterized by a wide disparity between countries--and also within countries, between the rural regions and between large and small cities. The density of anaesthesiologists varies in different European areas--for example, 4.4 per 100,000 inhabitants in Ireland compared to 15.6 in Italy; conversely, trainee anaesthesiologists are more numerous in those countries in which the number of qualified specialists is low. ⋯ Important modifications could come from an increase in the workload, a decrease in the working time, and perhaps from the development of migratory flows when Eastern European countries join the European Union. The evolution of anaesthesiology in the future will depend on many unknown events: progress in pharmacology and techniques, the development of day-case anaesthesia, the behaviour of new consumers and, above all, future health policies.
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Best Pract Res Clin Anaesthesiol · Sep 2002
Appraisal and reassessment of the specialist in anaesthesia.
Appraisal and reassessment of the physician is an integral part of ensuring that 'quality of care' provided by the health care system is the best possible within the constraint of resources. Assessment tools used for initial certification at completion of medical school as a general physician and for initial certification as an anaesthesiologist are discussed. The expansion of core or general physician competencies to include behavioural, communication and evidence-based resource management skills in addition to knowledge and clinical skills is reviewed. ⋯ Examples of each level are given. Re-certification of anaesthesiologists currently occurs in two distinct ways: by examination and through continuing medical education. Details of each approach are included.