A Survey of Simulation Utilization in Anesthesiology Residency Programs in the United States

Abstract

Given the evolution of competency-based education and evidence supporting the benefits of incorporating simulation into anesthesiology residency training, simulation will likely play an important role in the training and assessment of anesthesiology residents. Currently, there are little data available regarding the current status of simulation-based curricula across US residency programs. In this study, we assessed simulation-based training and assessment in US anesthesiology programs using a survey designed to elicit information regarding the type, frequency, and content of the simulation courses offered at the 132 Accreditation Council of Graduate Medical Education-certified anesthesiology training programs. The response rate for the survey was 66%. Although most of the responding programs offered simulation-based courses for interns and residents and during CA-1 orientation, the curriculum varied greatly among programs. Approximately 40% of responding programs use simulation for resident assessment and remediation. The majority of responding programs favored standard simulation-based training as part of residency training (89%), and the most common perceived obstacles to doing so were time, money, and human resources. The results from this survey highlight that there are currently large variations in simulation-based training and assessment among training programs. It also confirms that many program directors feel that standardizing some components of simulation-based education and assessment would be beneficial. Given the positive impact simulation has on skill retention and operating room preparedness, it may be worthwhile to consider developing a standard curriculum.

Simulation-based education and training in anaesthesia during residency in Europe: where are we now?

“…The most frequently cited were finance and cost (reported by 79% of these countries), lack of protected education time for residents (57%), lack of regulations or executive support (46%), lack of resources for simulation curriculum development (43%), lack of access to existing centres (32%), lack of trained instructors (28%), lack of dedicated space (25%), lack of motivation/enthusiasm for this method of training (21%). Similar issues have been reported in North America 2,3 . Nevertheless, Denmark, Ireland, Malta, the Netherlands and Iceland have successfully implemented mandatory SBET into their curriculum.…”

“…Increased BMI has shown to be associated with increased surgical complexity and uterine atony, both of which are factors for longer duration of caesarean surgery. 2 Furthermore, the mean duration of surgery reported in the study was 45 min, which is not necessarily the 'standard usual' for most centres, including ours. The duration of action of intrathecal local anaesthetics needs to take into account any unpredictable prolongation ofsurgical duration due to previous caesarean sections, uterine atony, maternal obesity and unanticipated surgical complications, amongst others.…”

“…Similar issues have been reported in North America. 2,3 Nevertheless, Denmark, Ireland, Malta, the Netherlands and Iceland have successfully implemented mandatory SBET into their curriculum. The reasons behind their achievement are probably a mix of strong political and executive support, adequate funding, and regulations imposing external requirements which result in co-ordination between centres.…”

Modules for the Technical Skills Section of the OSCE Component of the American Board of Anesthesiology APPLIED Examination

“…2 Recent surveys of anesthesiology training programs suggest that many programs may not have the number of faculty or financial support needed to be able to provide this type of training for their residents. 4,10 Preparation for both components of the OSCE is vital as all current residents must now undergo this portion as part of the board certification process. We believe that our instructional videos can encourage and assist other training programs to develop these valuable educational modules.…”

Defining and Addressing Anesthesiology Needs in Simulation-based Medical Education

“…To better understand the status of and potential barriers to SBME in the United States, a national needs assessment survey was undertaken. Although preexisting surveys have assessed SBME utilization, [20][21][22] to our knowledge only 1 published findings regarding SBME use among anesthesiologists 21 since the 2020 changes to Accreditation Council for Graduate Medical Education (ACGME) milestones, which emphasize competencybased training and objective performance measures. 23 Because the aforementioned study focused on pediatric anesthesia fellowship programs, 21 there is a knowledge gap in assessing anesthesiology residency programs' SBME utilization.…”