The journal of education in perioperative medicine : JEPM最新文献

Background: High learner engagement is important for the success of asynchronous and online learning for graduate medical education. Medical trainees have recently reported using medical mobile apps. App-based interactions may provide more participation than email-based interactions. We sought to investigate (1) if there were higher levels of engagement with an online curriculum using notifications sent via email as compared with via text, and (2) if there were higher levels of engagement with the mobile app or website format.

Methods: We implemented an online Journal Club curriculum with weekly topics for anesthesiology residents (postgraduate years 2-4) from July 2020 to June 2021. Weekly notifications were sent to residents via email for weeks 1-10, text for weeks 11-20, then email for weeks 21-49. Based on activity logs, we compared (1) the weekly numbers of interactions when email notifications were sent with the weekly numbers of interactions when text notifications were sent, and (2) the weekly numbers of interactions via the app with the weekly numbers of interactions via the website.

Results: Thirty-eight of the 54 anesthesiology residents in our department at the time of the study (70.4%) interacted with the online Journal Club at least once throughout the study. The weekly numbers of interactions with email notifications (median [interquartile range (IQR)]: 13 [7-28]) were significantly higher than with text notifications (median [IQR]: 6 [4-8]) (P = .023). The weekly numbers of interactions via the website (median [IQR]: 9 [4-24]) were significantly higher than via the app (median [IQR]: 0 [0-1]) (P < .001).

Conclusions: Although mobile technology may increase engagement and participation for some educational resources, learners may prefer accessing others through more conventional methods.

Background: High levels of empathy among resident physicians are associated with improved patient outcomes. Empathy may be learned and practiced when reading nonmedical writing through narrative transportation, a process by which readers identify with characters and become emotionally involved in the plot. We hypothesized that residents and fellows who reported more nonmedical reading would have higher empathy levels and that empathy would decrease during training.

Methods: An emailed survey was sent to program directors of Accreditation Council on Graduate Medical Education-accredited anesthesiology residency and fellowship programs, with a request to distribute the survey to trainees. The Toronto Empathy Questionnaire, reading volume, and demographics were included in the survey. Response data were analyzed using a multiple variable regression model.

Results: Of 136 responses, 119 were included for data analysis. Seventeen partially completed surveys were excluded. Higher empathy scores were reported among women (P < .0001) and residents who worked 60 to 80 hours per week (P = .039). Age, postgraduate year of training, relationship status, time spent with family, and avid reading were not significantly associated with increased empathy.

Conclusion: In this study, we examined whether nonmedical fiction reading would increase empathy in medical trainees. Our study was not able to find any significant association with time spent reading and increased empathy; however, we found that trainees who worked more hours, specifically 60 to 80 hours, had higher empathy scores. Limitations for this study included a smaller sample size. Further research should be done in this field to determine if there are other intangible factors that affect empathy in trainees.

Background: Simulations are a critical component of anesthesia education, and ways to broaden their delivery and accessibility should be studied. The primary aim was to characterize anesthesiology resident, fellow, and faculty experience with augmented reality (AR) simulations. The secondary aim was to explore the feasibility of quantifying performance using integrated eye-tracking technology.

Methods: This was a prospective, mixed-methods study using qualitative thematic analysis of user feedback and quantitative analysis of gaze patterns. The study was conducted at a large academic medical center in Northern California. Participants included 7 anesthesiology residents, 6 cardiac anesthesiology fellows, and 5 cardiac anesthesiology attendings. Each subject participated in an AR simulation involving resuscitation of a patient with pericardial tamponade. Postsimulation interviews elicited user feedback, and eye-tracking data were analyzed for gaze duration and latency.

Results: Thematic analysis revealed 5 domains of user experience: global assessment, spectrum of immersion, comparative assessment, operational potential, and human-technology interface. Participants reported a positive learning experience and cited AR technology's portability, flexibility, and cost-efficiency as qualities that may expand access to simulation training. Exploratory analyses of gaze patterns suggested that trainees had increased gaze duration of vital signs and gaze latency of malignant arrythmias compared with attendings. Limitations of the study include lack of a control group and underpowered statistical analyses of gaze data.

Conclusions: This study suggests positive user perception of AR as a novel modality for medical simulation training. AR technology may increase exposure to simulation education and offer eye-tracking analyses of learner performance.

Introduction: The Society for Education in Anesthesia (SEA) promotes dissemination of discoveries and innovations. We investigated the rate of publication of SEA Spring Meeting abstracts, hypothesizing that Research abstracts were published more frequently than Innovative Curriculum abstracts. We also studied the time between abstract presentation and publication and tracked the journals in which they were published.

Methods: All abstracts presented at SEA spring meetings from 2011-2019 were included. We searched PubMed for published articles that were based on those SEA abstracts. We calculated the overall publication rate and the respective publication rates for Research and Innovative Curriculum abstracts. We calculated odds ratio (OR) and performed the Pearson χ² test to compare publication rates between Research abstracts and Innovative Curriculum abstracts. We calculated the mean number of years between meeting presentation and publication and tabulated the number of works published in each journal.

Results: A total of 351 abstracts (128 Research and 223 Curriculum) were presented at SEA spring meetings. The overall publication rate was 15% (52/351). Research abstracts were published more frequently than Curriculum abstracts: 24.2% (31/128) versus 9.4% (21/223); OR = 3.1 (95% confidence interval, 1.7-5.6); P = .0003. The mean time from presentation to publication was 1.7 ± 1.3 years. The works appeared in 20 different journals.

Conclusion: SEA Spring Meeting abstracts were published less frequently than abstracts from other medical professional society meetings (21%-72.3%). Although the lower publication rate of Innovative Curriculum abstracts unique to the SEA meeting largely explains this shortfall, a relatively low publication rate, even for the Research abstracts, signals opportunities for growth.

Background: Breaking bad news (BBN) is an important clinical task for physicians. Unfortunately, there is no standard method to teach and assess these skills of anesthesiologists. Although anesthesiology has become a relatively safe medical specialty, complications still occur that require disclosure to patients and their families. Disclosure of bad news can be a significant source of stress for clinicians, especially for those who have low confidence in their BBN skills. Anesthesiologists' skills in BBN can be improved with simulation-based mastery learning (SBML), an intense form of competency-based learning.

Methods: An SBML curriculum was developed using the SPIKES (Situation, Perception, Invitation, Knowledge, Emotion, Summarize) framework for BBN and the NURSE (Naming, Understanding, Respecting, Supporting, Exploring) statements for expressing empathy. A pretest-posttest study was conducted from March 2020 to June 2022 to evaluate anesthesiologists' performance in BBN. Participants completed a 2-hour curriculum consisting of a pretest, didactic session, deliberate practice with feedback, and a posttest. Anesthesiologists were assessed using a 16-item skills checklist.

Results: Six anesthesiology attendings and 14 anesthesiology fellows were enrolled in the study. Three of 20 participants met the minimum passing score (MPS) at the time of their pretest. All study participants met the MPS on their first posttest (P < .001). The median participant confidence in BBN significantly increased (3 to 4, P < .001). Overall course satisfaction in the curriculum was high, with a median score of 5.

Conclusions: Our study demonstrates that a BBN SBML curriculum for anesthesiologists significantly improved communication skills and confidence in a simulated environment. Because only 3 participants met the MPS before training, our results suggest that anesthesiologists could benefit from further education to gain effective communication skills and that SBML training may be effective to achieve this result.

Background: This study reviews and appraises the articles published about anesthesiology education in 2020. The objective is to highlight high-quality evidence while showcasing articles with innovative ideas and high relevance to the practices of the anesthesiology education community.

Methods: Three Ovid MEDLINE databases, Embase.com, ERIC, PsycINFO, and PubMed were searched, followed by a manual review of articles published in the highest impact factor journals in both the fields of anesthesiology and medical education. Abstracts were double screened, and quantitative articles were subsequently scored by 3 randomly assigned raters. Qualitative studies were scored by 2 raters. Two different rubrics were used for scoring quantitative and qualitative studies. In addition, reviewers rated each article on its overall quality to create an additional list of top articles based solely on the opinion of the reviewers.

Results: A total of 2,491 citations were identified through the search criteria and the manual review. Of those, 61 articles met the inclusion criteria (57 quantitative and 4 qualitative). The top 12 quantitative papers and the top qualitative papers with the highest scores are reported and summarized.

Conclusions: We found that teaching clinical procedures continues to be a topic of interest, with more studies of improved rigor identified. New trends in wellness studies and increasing attention to distance learning and technology-assisted instructional methods were additional topics covered over the year.

Background: The objective of this study was to evaluate the impact of engaging in preparatory expansive posing on the performance of anesthesiology trainees during a mock structured oral examination.

Methods: A total of 38 clinical residents at a single institution participated in this prospective randomized controlled study. Participants were stratified by clinical anesthesia year and randomly assigned to 1 of 2 orientation rooms to prepare for the examination. The preparatory expansive posing participants stood for 2 minutes with their hands and arms above their heads and with their feet approximately 1 ft apart. Conversely, the control participants sat quietly in a chair for 2 minutes. All participants then received the same orientation and examination. Faculty evaluation of resident performance, residents' self-assessment of performance, and anxiety score were collected.

Results: There was no evidence to support our primary hypothesis that residents who engaged in preparatory expansive posing for 2 minutes prior to a mock structured oral examination would score higher than their control counterparts (P = .68). There was no evidence to support our secondary hypotheses that preparatory expansive posing increases self-assessment of one's performance (P = .31) or reduces perceived anxiety during a mock structured oral examination (P = .85).

Conclusions: Preparatory expansive posing did not improve anesthesiology residents' mock structured oral examination performance or self-assessment of their performance, nor did it reduce their perceived anxiety. Preparatory expansive posing is likely not a useful technique in improving the performance of residents in structured oral examinations.