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1.
A A Pract ; 15(2): e01406, 2021 Feb 23.
Article in English | MEDLINE | ID: covidwho-1869126

ABSTRACT

The Internet is a source of professional self-education for medical students and residents. Unfortunately, much of the content discovered through search engines is of insufficient quality for professional education. The Anesthesia Toolbox (AT) was developed to provide online peer-reviewed educational resources for anesthesiology trainees and faculty. Since 2014, AT has developed 24 curricula, 822 content items, and 3238 quiz questions. As of March 2020, 64 anesthesiology residency programs in the United States subscribed to the AT (41% of total). Since the onset of the pandemic in March, AT has added 25 programs (28% increase) and gained 1156 users (26% increase).


Subject(s)
Anesthesia , Anesthesiology , Computer-Assisted Instruction , Internship and Residency , Anesthesiology/education , Humans , Surveys and Questionnaires , United States
3.
Braz J Anesthesiol ; 72(2): 185-188, 2022.
Article in English | MEDLINE | ID: covidwho-1670226

ABSTRACT

BACKGROUND: Simulation-based education has become the most important part of resident training in anesthesiology, especially during the pandemic. It allows learning the skills and the management of different situations without putting residents in risk of contamination, considering COVID-19 is highly contagious. The hypothesis was that simulation is still associated with improvement of knowledge acquisitions despite the context of the COVID-19 pandemic. METHODS: Residents of anesthesiology and intensive care subjected to an anaphylaxis simulation scenario. Their knowledge levels were assessed by true/false questions before and one month after the simulation session. The STAI test was used to measure anxiety levels before and after the scenario. Data were analyzed statistically using Wilcoxon and McNemar tests. RESULTS: Junior residents (< 2 years) received significantly higher scores in post-training theoretical tests compared to their pre-training scores (79.2 ± 9.6, 84.5 ± 8.2, p = 0.002, n = 21). There was no difference between pre- and post-test scores of seniors (80.2 ± 9, 81.8 ± 10.4, p = 0.3). Pre- and post-anxiety inventory scores were nearly the same and both were in the moderate group (39.8 ± 10.1, 39.3 ± 12.1, p = 0.8). CONCLUSION: Simulation-based education improved the knowledge levels of the residents without raising anxiety levels. Thus, simulation-based training showed its value as an important tool of education during the pandemic, which needs to be further popularized for training at all institutions. Enlightening medical educators about this accomplished teaching method may lead to improved quality of medical education in developing countries and reshape how tomorrow's doctors are trained during pandemics.


Subject(s)
Anesthesiology , COVID-19 , Internship and Residency , Simulation Training , Anesthesiology/education , Clinical Competence , Humans , Operating Rooms , Pandemics
4.
Anesth Analg ; 133(5): 1331-1341, 2021 Nov 01.
Article in English | MEDLINE | ID: covidwho-1566542

ABSTRACT

In 2020, the coronavirus disease 2019 (COVID-19) pandemic interrupted the administration of the APPLIED Examination, the final part of the American Board of Anesthesiology (ABA) staged examination system for initial certification. In response, the ABA developed, piloted, and implemented an Internet-based "virtual" form of the examination to allow administration of both components of the APPLIED Exam (Standardized Oral Examination and Objective Structured Clinical Examination) when it was impractical and unsafe for candidates and examiners to travel and have in-person interactions. This article describes the development of the ABA virtual APPLIED Examination, including its rationale, examination format, technology infrastructure, candidate communication, and examiner training. Although the logistics are formidable, we report a methodology for successfully introducing a large-scale, high-stakes, 2-element, remote examination that replicates previously validated assessments.


Subject(s)
Anesthesiology/education , COVID-19/epidemiology , Certification/methods , Computer-Assisted Instruction/methods , Educational Measurement/methods , Specialty Boards , Anesthesiology/standards , COVID-19/prevention & control , Certification/standards , Clinical Competence/standards , Computer-Assisted Instruction/standards , Educational Measurement/standards , Humans , Internship and Residency/methods , Internship and Residency/standards , Specialty Boards/standards , United States/epidemiology
5.
BMC Med Educ ; 21(1): 609, 2021 Dec 09.
Article in English | MEDLINE | ID: covidwho-1566521

ABSTRACT

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.


Subject(s)
Anesthesia , Anesthesiology , COVID-19 , Anesthesiology/education , Humans , Learning , SARS-CoV-2 , Teaching
6.
Anasthesiol Intensivmed Notfallmed Schmerzther ; 56(11-12): 782-790, 2021 Dec.
Article in German | MEDLINE | ID: covidwho-1532178

ABSTRACT

On March 14, 2020, the first Bavaria-wide exit restriction was imposed and university teaching in its familiar form was drastically restricted. For intensive care physicians and anesthetists, there was a special area of tension in many places due to the extraordinary demand for the treatment of critically ill patients and the restructuring and maintenance of teaching. We report on the realignment of the anesthesia seminar in an online flipped classroom and the development towards a hybrid model. As such, an adequate transfer of knowledge could take place under difficult conditions and at the same time the teaching concept could be further developed.


Subject(s)
Anesthesia , Anesthesiology , COVID-19 , Physicians , Anesthesiology/education , Humans , SARS-CoV-2 , Teaching
7.
Anesthesiol Clin ; 39(4): 649-665, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1509560

ABSTRACT

Simulation has played a critical role in medicine for decades as a pedagogical and assessment tool. The labor and delivery unit provides an ideal setting for the use of simulation technology. Prior reviews of this topic have focused on simulation for individual and team training and assessment. The COVID-19 pandemic has provided an opportunity for educators and leaders in obstetric anesthesiology to rapidly train health care providers and develop new protocols for patient care with simulation. This review surveys new developments in simulation for obstetric anesthesiology with an emphasis on simulation use during the COVID-19 pandemic.


Subject(s)
Anesthesiology , COVID-19 , Obstetrics , Simulation Training , Anesthesiology/education , Clinical Competence , Female , Humans , Obstetrics/education , Pandemics , Patient Simulation , Pregnancy , SARS-CoV-2
9.
J Surg Educ ; 79(2): 330-341, 2022.
Article in English | MEDLINE | ID: covidwho-1415618

ABSTRACT

OBJECTIVE: The SARS-CoV-2 (COVID-19) pandemic has profoundly impacted healthcare delivery and strained medical training. This study explores resident and faculty perceptions regarding the impact of the COVID-19 crisis on technical skill decay of surgical and anesthesia residents. We hypothesized that many residents perceived that their technical abilities diminished due to a short period of interruption in their training. DESIGN: An IRB-exempt, web-based cross-sectional survey distributed to residents and faculty SETTING: Two large academic tertiary medical centers, North Shore University Hospital and Long Island Jewish Medical Center, of the Northwell Health System in New York. PARTICIPANTS: General surgery, anesthesiology, plastic surgery, cardiothoracic surgery, orthopedic surgery, oral maxillofacial surgery, urology, podiatry residents and faculty. RESULTS: All residents reported a significant impact on their training. Residents (82%) and faculty (94%) reported a significant reduction in case volumes due to the COVID-19 pandemic (p < 0.05). 64% of residents reported a reduction in technical skills, and 75% of faculty perceived a decrease in resident technical skills. Residents were concerned about fulfilling ACGME case requirements, however faculty were more optimistic that residents would achieve level-appropriate proficiency by the conclusion of their training. Both residents and faculty felt that resident critical care skills improved as a result of redeployment to COVID-19 intensive care units (66% and 94%). Additionally, residents reported increased confidence in their ability to care for critically ill patients and positive impact on professional competencies. CONCLUSIONS: Effects of the COVID-19 pandemic on residency training are multi-dimensional. The majority of surgical and anesthesia residents perceived that their technical ability diminished as a result of skill decay, whereas other skillsets improved. Longitudinal surveillance of trainees is warranted to evaluate the effect of reduced operative volume and redeployment on professional competency.


Subject(s)
Anesthesia , Anesthesiology , COVID-19 , General Surgery , Internship and Residency , Anesthesiology/education , Clinical Competence , Cross-Sectional Studies , General Surgery/education , Humans , Pandemics , SARS-CoV-2
11.
MedEdPORTAL ; 17: 11134, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1170589

ABSTRACT

Introduction: In a CICO (cannot intubate, cannot oxygenate) situation, anesthesiologists and acute care physicians must be able to perform an emergency surgical cricothyrotomy (front-of-neck airway procedure). CICOs are high-acuity situations with rare opportunities for safe practice. In COVID-19 airway management guidelines, bougie-assisted surgical cricothyrotomy is the recommended emergency strategy for CICO situations. Methods: We designed a 4-hour procedural simulation workshop on surgical cricothyrotomy to train 16 medical residents. We provided prerequisite readings, a lecture, and a videotaped demonstration. Two clinical scenarios introduced deliberate practice on partial-task neck simulators and fresh human cadavers. We segmented an evidence-based procedure and asked participants to verbalize the five steps of the procedure on multiple occasions. Results: Thirty-two residents who participated in the workshops were surveyed, with a 97% response rate (16 of 16 from anesthesiology, 15 of 16 from emergency medicine). Participants commented positively on the workshop's authenticity, its structure, the quality of the feedback provided, and its perceived impact on improving skills in surgical cricothyrotomy. We analyzed narrative comments related to three domains: preparation for the procedure, performing the procedure, and maintaining the skills. Participants highlighted the importance of performing the procedure many times and mentioned the representativeness of fresh cadavers. Discussion: We developed a surgical cricothyrotomy simulation workshop for anesthesiology and emergency medicine residents. Residents in the two specialities uniformly appreciated its format and content. We identified common pitfalls when executing the procedure and provided practical tips and material to facilitate implementation, in particular to face the COVID-19 pandemic.


Subject(s)
Anesthesiology/education , COVID-19/surgery , Emergency Medicine/education , Internship and Residency , Simulation Training , Tracheostomy/education , Adult , Airway Management/methods , Cadaver , Humans , Pandemics , Tracheostomy/methods
12.
Anesthesiol Clin ; 39(2): 353-361, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1157112

ABSTRACT

COVID-19 challenged many facets of medicine. At the frontlines of managing the health care of the infected were anesthesiologists and critical care physicians, especially those in large cities. The Hospital of the University of Pennsylvania [HUP] was no exception. Through simulations, online education platforms, and most importantly creative scheduling that allows acquisition of skills and ACGME milestones to be met, COVID-19 allowed the Department of Anesthesiology and Critical Care at HUP to meet the challenges presented during the surge and create a template for future challenges to the US health care system.


Subject(s)
Anesthesiology/education , COVID-19 , Internship and Residency/trends , Pandemics , Anesthesiologists , Clinical Competence , Health Resources , Humans , Personnel Staffing and Scheduling , Professional Role
14.
Anesth Analg ; 132(3): 585-593, 2021 03 01.
Article in English | MEDLINE | ID: covidwho-1133642

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has altered approaches to anesthesiology education by shifting educational paradigms. This vision article discusses pre-COVID-19 educational methodologies and best evidence, adaptations required under COVID-19, and evidence for these modifications, and suggests future directions for anesthesiology education. Learning management systems provide structure to online learning. They have been increasingly utilized to improve access to didactic materials asynchronously. Despite some historic reservations, the pandemic has necessitated a rapid uptake across programs. Commercially available systems offer a wide range of peer-reviewed curricular options. The flipped classroom promotes learning foundational knowledge before teaching sessions with a focus on application during structured didactics. There is growing evidence that this approach is preferred by learners and may increase knowledge gain. The flipped classroom works well with learning management systems to disseminate focused preclass work. Care must be taken to keep virtual sessions interactive. Simulation, already used in anesthesiology, has been critical in preparation for the care of COVID-19 patients. Multidisciplinary, in situ simulations allow for rapid dissemination of new team workflows. Physical distancing and reduced availability of providers have required more sessions. Early pandemic decreases in operating volumes have allowed for this; future planning will have to incorporate smaller groups, sanitizing of equipment, and attention to use of personal protective equipment. Effective technical skills training requires instruction to mastery levels, use of deliberate practice, and high-quality feedback. Reduced sizes of skill-training workshops and approaches for feedback that are not in-person will be required. Mock oral and objective structured clinical examination (OSCE) allow for training and assessment of competencies often not addressed otherwise. They provide formative and summative data and objective measurements of Accreditation Council for Graduate Medical Education (ACGME) milestones. They also allow for preparation for the American Board of Anesthesiology (ABA) APPLIED examination. Adaptations to teleconferencing or videoconferencing can allow for continued use. Benefits of teaching in this new era include enhanced availability of asynchronous learning and opportunities to apply universal, expert-driven curricula. Burdens include decreased social interactions and potential need for an increased amount of smaller, live sessions. Acquiring learning management systems and holding more frequent simulation and skills sessions with fewer learners may increase cost. With the increasing dependency on multimedia and technology support for teaching and learning, one important focus of educational research is on the development and evaluation of strategies that reduce extraneous processing and manage essential and generative processing in virtual learning environments. Collaboration to identify and implement best practices has the potential to improve education for all learners.


Subject(s)
Anesthesiologists , Anesthesiology/education , Anesthesiology/methods , COVID-19/epidemiology , COVID-19/prevention & control , Curriculum , Anesthesia , Clinical Competence , Computer Simulation , Education, Distance , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Interdisciplinary Research , Learning , Pandemics , Teaching , Workflow
15.
Anesth Analg ; 132(3): 605-615, 2021 Mar 01.
Article in English | MEDLINE | ID: covidwho-1133641

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic is a public health crisis of unprecedented proportions that has altered the practice of medicine. The pandemic has required pain clinics to transition from in-person visits to telemedicine, postpone procedures, and cancel face-to-face educational sessions. There are no data on how fellowship programs have adapted. METHODS: A 17-question survey was developed covering topics including changes in education, clinical care, and psychological stress due to the COVID pandemic. The initial survey was hosted by Qualtrics Inc and disseminated by the Association of Pain Program Directors on April 10, 2020, to program directors at Accreditation Council for Graduate Medical Education (ACGME)-accredited fellowships. Results are reported descriptively and stratified by COVID infection rate, which was calculated from Centers for Disease Control and Prevention data on state infections, and census data. RESULTS: Among 107 surveys distributed, 70 (65%) programs responded. Twenty-nine programs were located in states in the upper tertile for per capita infection rates, 17 in the middle third, and 23 in the lowest tertile. Nearly all programs (93%) reported a decreased workload, with 11 (16%) reporting a dramatic decrease (only urgent or emergent cases). Just more than half of programs had either already deployed (14%) or credentialed (39%) fellows to provide nonpain care. Higher state infection rates were significantly associated with reduced clinical demand (Rs = 0.31, 95% confidence interval [CI], 0.08-0.51; P = .011) and redeployment of fellows to nonpain areas (Rs = 0.30, 95% CI, 0.07-0.50; P = .013). Larger program size but not infection rate was associated with increased perceived anxiety level of trainees. CONCLUSIONS: We found a shift to online alternatives for clinical care and education, with correlations between per capita infection rates, and clinical care demands and redeployment, but not with overall trainee anxiety levels. It is likely that medicine in general, and pain medicine in particular, will change after COVID-19, with greater emphasis on telemedicine, virtual education, and greater national and international cooperation. Physicians should be prepared for these changes.


Subject(s)
Anesthesiology/education , Anesthesiology/methods , COVID-19 , Pain Management/methods , Pandemics , Accreditation , Anesthesiologists , Anxiety , Education, Medical, Graduate/methods , Fellowships and Scholarships , Humans , Stress, Psychological , Surveys and Questionnaires , Telemedicine
16.
Ann Surg ; 273(4): e125-e126, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1132687

ABSTRACT

The SARS-CoV-2 pandemic has highlighted existing systemic inequities that adversely affect a variety of communities in the United States. These inequities have a direct and adverse impact on the healthcare of our patient population. While civic engagement has not been cultivated in surgical and anesthesia training, we maintain that it is inherent to the core role of the role of a physician. This is supported by moral imperative, professional responsibility, and a legal obligation. We propose that such civic engagement and social justice activism is a neglected, but necessary aspect of physician training. We propose the implementation of a civic advocacy education agenda across department, community and national platforms. Surgical and anesthesiology residency training needs to evolve to the meet these increasing demands.


Subject(s)
Anesthesiology/education , Education, Medical, Graduate/methods , Health Status Disparities , Healthcare Disparities , Physician's Role , Social Justice/education , Specialties, Surgical/education , Anesthesiology/ethics , Education, Medical, Graduate/ethics , Health Policy , Healthcare Disparities/ethics , Humans , Patient Advocacy/education , Patient Advocacy/ethics , Social Justice/ethics , Specialties, Surgical/ethics , United States
17.
Anesthesiol Clin ; 39(2): 255-264, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1077760

ABSTRACT

This article documents experiences from frontline anesthesia providers in Wuhan, China, mainly from the anesthesiologists in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. Those experiences offer valuable insight into the processes used to optimize the emergency response system, and the medical resources and emergency allocation, as well as providing information on the role anesthesiologists played in managing the pandemic.


Subject(s)
Anesthesiology/trends , COVID-19 , Pandemics , Anesthesiology/education , China , Clinical Competence , Humans , Personal Protective Equipment
18.
J Clin Anesth ; 70: 110192, 2021 06.
Article in English | MEDLINE | ID: covidwho-1065301

ABSTRACT

STUDY OBJECTIVE: Anesthesiologists have a high prevalence of burnout with adverse effects on professionalism and safety. The objective of this study was to assess the impact of an interactive anesthesiology educational program on the wellness of anesthesia providers and their children, as assessed by a modified Professional Fulfillment Index. DESIGN: Prospective observational study. SETTING: Perioperative area. PATIENTS: Thirty clinicians participated in the program. Twenty respondents, representing 67% of participants and each corresponding to a parent and their child or children, completed the post-event survey. INTERVENTIONS: An interactive anesthesiology educational program incorporating children, between the ages of five and eighteen years old, of anesthesia providers was held in the perioperative area. The program was held over four hours and was comprised of four sessions including pediatric anesthesia, neuroanesthesia, airway, and ultrasound stations. MEASUREMENTS: Anesthesia providers and their children were administered a post-event assessment, including a modified Professional Fulfillment Index and satisfaction survey. MAIN RESULTS: All twenty (100%) of respondents indicated it was "very true" or "completely true" that their child was happy with the program, and that it was worthwhile and satisfying to both the anesthesia provider and their child. Nineteen (95%) of reporting participants indicated it was "very true" or "completely true" that it was meaningful to have the department host such a program and 17 (85%) respondents felt their child now better understands the anesthesia work of the parent. All clinician volunteers indicated it was "very true" or "completely true" that they were contributing professionally during the program in ways that they valued most. CONCLUSION: An interactive educational wellness initiative provides an effective and feasible method for increasing professional fulfillment and satisfaction among anesthesia providers while educating our youngest generation of learners. Implementation of such a program may also occur with modifications such as televideo to maintain COVID-19 precautions.


Subject(s)
Anesthesiologists/psychology , Anesthesiology/education , Burnout, Professional/prevention & control , Adolescent , Child , Child, Preschool , Female , Humans , Male , Personal Satisfaction , Prospective Studies
19.
Paediatr Anaesth ; 31(3): 268-274, 2021 03.
Article in English | MEDLINE | ID: covidwho-991653

ABSTRACT

BACKGROUND: The global coronavirus disease 2019 (COVID-19) pandemic caused state-wide shutdowns of elective surgical activities in March and April of 2020 forcing graduate medical education program directors and their trainees in the United States to quickly adapt to new rules and circumstances. AIM: The aim of this study was to determine the effect of the current pandemic on pediatric anesthesiology fellow education and wellness nationally in order to guide creation of optimal support systems for fellows during the ongoing pandemic. METHODS: In July 2020, an electronically distributed survey was sent to all United States-based pediatric anesthesiology fellowship program directors who were asked to distribute the survey to all current/graduating fellows. RESULTS: A total of 75 out of 184 pediatric anesthesiology fellows (41%) responded to the survey. Major domains identified include reduction of clinical time, financial impact, mental health/wellness effects, and concerns about the overall quality of the fellowship educational experience. Respondents indicated that the pandemic has led to personal quarantine (and/or illness) leave time (21.3%), changes in finances (42.7%) and career opportunities (37.3%), decreased clinical education/experience (28%), and a dissatisfaction with the modified didactic experience (22.7%). In addition, a majority of respondents (97.3%) experienced increased stressors during this pandemic, including worry for family members (80%), stress due to changes in certifying examinations (76%), and fear of contracting COVID-19 from a patient (72%). CONCLUSION: While the results of this survey are only one snapshot in time during an evolving pandemic, these results highlight important domains where program directors and other departmental leaders might focus limited resources to maximize the educational experiences and overall wellness for pediatric anesthesiology fellows.


Subject(s)
Anesthesiology/education , COVID-19/prevention & control , Fellowships and Scholarships/methods , Health Status , Mental Health , Pediatrics/education , Education, Medical, Graduate/methods , Health Surveys/methods , Health Surveys/statistics & numerical data , Humans , Pandemics , SARS-CoV-2 , United States
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