Professor, Anesthesia and Perioperative Care and Medicine
Vice Dean, Affiliations, Compliance and Regulatory Affairs
Director, International Programs, UCSF School of Medicine, San Francisco, CA
Director and Attending Physician, Multidisciplinary Critical Care Medicine
Chair, Board of Directors, El Camino Hospital, Mountain View, CA USA
Medical Director, International Medical Services, UCSF
Director, Risk Management and Compliance, UCSF
Chair, Section on Professional Practice,
American Society of Anesthesiologists
Transforming Medical Education in Anesthesiology: Advancing Clinical Practice through New Educational Initiatives During Training and Beyond
Advances in the practice of anesthesia have had major impact on anesthesia training programs. In response to the expanding fund of knowledge, scope of practice and required clinical skills, training programs have had to reassess the curriculum and identify new ways for their residents to gain the diverse skills and experience as well as to validate that the resident completing training is prepared for the transition to practice. This lecture will provide an overview of some of these changes taking place in resident education and evaluation.
One of the challenges facing every residency program is to ensure that residents gain training in all aspects of anesthesia care, critical care medicine, pain medicine and associated clinical activities. In many programs, the clinical volume and diversity of experience may not support the educational needs. To address this challenge, this session will describe some alternative methods to optimize the clinical experience, including simulation and other alternative options. Exposure to the potential opportunities in telemedicine as an adjunct to face-to-face care is also becoming an essential educational goal.
While these new initiatives are exciting and create opportunities to expand anesthesia practices outside of the traditional intraoperative environment, they create another challenge -- the need to ensure that residents not only have broad exposure to the full scope of anesthesia practice, but also document that the residents acquire the necessary competencies to advance through their training and transition to independent practice. The discussion will describe the use of milestones and "entrustable professional activities" (EPAs) as evaluation tools to guide professional development through the continuum of training, identify potential deficits and provide opportunities to address them.
In addition to the overview of some of the traditional educational imperatives, the discussion will also outline some of the other educational opportunities to prepare residents for their future careers. Training in perioperative management and understanding the impact of intraoperative management on quality, outcomes and cost of care have become increasingly important. Many programs are also emphasizing some of the important administrative aspects of anesthesia care. Providing residents with the opportunity to develop management skills and a better understanding of personnel management, resource utilization as well as impacts of their decisionmaking on costs of care has provided invaluable experiences to allow the residents to assume broader roles in health care as they embark on their future practices.
Finally, the presentation will discuss ways in which training programs are addressing other critical issues affecting clinical practice and providers, including, but not limited to professionalism, well-being, fatigue, burnout and distractions, all of which impact the quality of care provided to patients as well as the overall environment in which our trainees work.