Anesthesia crisis resource management: Real-life simulation training in operating room crises

Review article: Closing the research gap at the interface of learning and clinical practice

“…11 Search of the references of these studies identified another 14 citations. With further analysis, articles were selected wherein interventions relevant to one or more of the three themes were studied, resulting in a final selection of 56 citations Twenty-one studies analyzed transitions in, during, and after residency education; 19 studies addressed the educational effects of duty hour limits, [33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51] and 16 articles presented research on use of the competencies in teaching and assessing anesthesiology residents. [19][20][21][22][23][24][25][26][27][52][53][54][55][56][57][58] For the theme ''duty hours and the acquisition of competence'', the only articles included were those that assessed the effect of duty hour limits on measures of physician competence and those that studied changes in patient care experience in anesthesiology that could be attributed to the reduction in resident hours.…”

“…In anesthesiology, much of the research has focused on technical skills, such as airway management and dealing with anesthesia crisis management, with frequent use of simulation for teaching and assessment. [19][20][21][22][23][24][25] The focus of other recent work that explicitly or implicitly mentioned educational transition has been on education in the ''business'' aspects of medicine 26 and leadership training for fellows. 27 Promising areas to prepare physicians for the transition into practice include enhanced preparation for providing culturally competent care; 28 end-of-life care, particularly for individuals in subspecialty training in pain medicine and critical care; 29 and the cost-effective use of medical resources.…”

“…At the macro level of the United States health care system, adoption of the aims of the Institute of Medicine promotes attributes and behaviours associated with a high-performance health care system. 19 While there is acknowledged conceptual legitimacy of the construct ''competencies'', 78-80 the key issue is that attempts to apply these to teaching and evaluation may create problems for evaluators for whom these deconstructed elements appear unrelated to the complex and frequently indiscernible ways they are integrated into clinical practice. 78,85,86 This is particularly true when the residents under observation have moved past the Dreyfuss' levels of ''novice'' and ''advanced beginner'' to ''competent'' and ''proficient.''…”

“…While the focus of much of the work in anesthesiology is still on medical knowledge and technical skills, [19][20][21][22][23][24][25] it is promising that the focus of recent research has been to improve adherence to care guidelines, 52 to validate and demonstrate the utility of the CanMEDS framework, 53 to contextualize professionalism, systems-based practice, and other non-technical skills for anesthesiologists, [54][55][56][57] and to put forward a model that will enable anesthesiology residents to integrate the competencies and the aims of the Institute of Medicine for the health care system. 58 The focus is on approaches to teach and assess the non-technical competencies, including the development of validated tools.…”

Review article: Simulation in anesthesia: state of the science and looking forward

“…The results of these studies showed that participants were generally very positive about their training, and they perceived their training as contributing to safe practice. [38][39][40][41][42][43][44] However, a few studies also showed that this form of education was intimidating and stressful for participants, 41 and only a minority (*30%) believed it had influenced their clinical practice. 45,46 Interestingly, there is also a growing body of evidence showing that self-reports of participants do not predict their actual levels of performance.…”