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BackgroundThe transition from internship to clinical anesthesiology (CA) training is often difficult given the differences in workflow, procedures, environment, and clinical situations. The primary aims of this study were to determine if a standardized introductory bootcamp could improve clinical knowledge and self-perceived comfort level of new anesthesiology residents in performing common operating room procedures and management of common intraoperative problems. The secondary aim of the study was to see if a standardized bootcamp could be replicated at other programs. MethodsThe introduction to anesthesiology resident bootcamp was developed at one institution in 2015 then expanded to a second program in 2019. The bootcamp was a one-day experience consisting of simulation and task trainers that all rising first-year CA residents (CA-1) participated in during their first month of anesthesiology training. All participating residents were given a survey immediately before and after the bootcamp. The average ratings of the questions were calculated and used as the primary measure. The Anesthesia Knowledge Test (AKT) was used as a surrogate measure of participant knowledge. ResultsFrom 2015 to 2020, a total of 105 residents completed the pre-survey and 109 completed the post-survey across the two sites. The improvement in average rating was significant (Pre: 2.04±0.46 versus Post: 3.09±0.52 p<0.0001). Individual item analysis also showed significant improvement on all of the eight items (p<0.0001). Analyses by site revealed the same results at both average score and item level. There was no significant cohort difference in either p=0.14) or AKT-1 (Control: 41.06±26.42 versus Intervention 41.70±26.60, p=0.90) percentile scores. ConclusionsIncorporation of an introduction to anesthesia bootcamp for new residents significantly improves participant comfort level and is reproducible across institutions. However, it does not improve resident performance on standardized tests.

Introduction: Crisis management is difficult to practice and evaluate for resident learners and leadership given the rarity of these events in clinical practice. However, simulation provides a medium to bridge this gap. We identified a need for simulation in our anesthesiology residency program to help residents learn to treat perioperative emergencies.Objective: To describe the process of curriculum development, content, and early outcomes of a simulationbased curriculum for the management of perioperative emergencies for all levels of anesthesiology learners.Materials and methods: Curriculum development began in the Spring of 2019 and simulations began in August 2019. All anesthesiology residents rotating at a single center through December 2020 were eligible. Each resident was given their own simulation scenario detailing a specific perioperative emergency and then debriefed as a group afterward. All residents participating in the scenario were given a post-simulation survey assessing the value of the educational experience, relevance to their level of training, and quality of learning environment.Results: Out of 90 eligible residents, 79 participated in the study (87%). Overall, 100% of participants completed the post-simulation survey; 100% of residents reported that the curriculum was useful to their education; 98% of residents reported that the curriculum was relevant to their training level; 99% of residents reported that the simulation was an engaging learning experience. Conclusion:A simulation-based curriculum of perioperative emergencies for anesthesiology residents is feasible to implement, viewed as worthwhile by trainees, and can foster education in a different learning environment.

Background Emergency manuals, which are safety essentials in non-medical high-reliability organizations (e.g., aviation), have recently gained acceptance in critical medical environments. Of the existing emergency manuals in anesthesiology, most are geared towards intraoperative settings. Additionally, most evidence supporting their efficacy focuses on the study of physicians with at least some meaningful experience as a physician. Our aim was to evaluate whether an emergency manual would improve the performance of novice physicians (post-graduate year [PGY] 1 or first year resident) in managing a critical event in the intensive care unit (ICU). Methods PGY1 interns (n=41) were assessed on the management of a simulated critical event (unstable bradycardia) in the ICU. Participants underwent a group allocation process to either a control group (n=18) or an intervention group (emergency manual provided, n=23). The number of successfully executed treatment and diagnostic interventions completed was evaluated over a ten minute (600 seconds) simulation for each participant. ResultsThe participants using the emergency manual averaged 9.9/12 (83%) interventions, compared to an average of 7.1/12 (59%) interventions (p < 0.01) in the control group. ConclusionsThe use of an emergency manual was associated with a significant improvement in critical event management by individual novice physicians in a simulated ICU patient (23% average increase). BackgroundEvery year a changeover of trainees occurs in teaching hospitals where novice physicians (PGY1), or interns, take on new responsibilities while simultaneously facing the stressors encountered at the beginning of residency.Consequently, evidence suggests that mortality increases and efficiency decreases in hospitals in the first month after year-end changeovers 1 . Reasons may include the loss of experienced staff, relative inexperience of each new group moving up in rank (e.g. new interns, new senior residents, and new supervisor physicians), and a general lack of institutional and tacit knowledge (e.g. new teams, figuring out "how we do things here"). In the context of these safety vulnerabilities, novice physicians may find themselves with the responsibility of managing acute lifethreatening events in various clinical settings 2,3 . Caring for