Deliberate Practice for Achieving and Maintaining Expertise in Anesthesiology

Abstract

For the dedicated anesthesiologist, a high level of expertise is needed to deliver good care to patients and to provide excellent service to surgeons, anesthesia colleagues, and others. Expertise helps the anesthesiologist recover from difficult situations and generally makes the practice run more effectively. Expertise also contributes to quality of life through higher self-esteem and long-term career satisfaction. We begin by reviewing the attributes that characterize expert performance and discussing how a specific training format, known as deliberate practice, contributes to acquisition and maintenance of expertise. Deliberate practice involves rehearsal of specific tasks to mastery, ideally under the eye of a mentor to provide feedback. This amounts to an orchestrated effort to improve that enables trainees to progress to expert levels of performance. With few exceptions, people who become recognized experts have pursued deliberate practice on the order of 4 hours per day for 10 to 15 years. In contrast, those who practice their profession in a rote manner see their skills plateau well below the level of top performers. Anesthesiology instruction with attending supervision provides all of the necessary components for deliberate practice, and it can be effective in anesthesia. Using deliberate practice in teaching requires organization in selecting training topics, effort in challenging students to excel, and skill in providing feedback. In this article, we discuss how educational programs can implement deliberate practice in anesthesiology training, review resources for instructors, and suggest how anesthesiologists can continue the practice after residency.

Comparative-Effectiveness of Simulation-Based Deliberate Practice Versus Self-Guided Practice on Resident Anesthesiologists’ Acquisition of Ultrasound-Guided Regional Anesthesia Skills

“…12,13 Deliberate practice training and the development of mastery learning have been applied to a few areas in medical education. 14,15 No study, to our knowledge, has studied the impact of deliberate practice as part of SBME in regional anesthesia. We designed this study to test the primary hypothesis that novice residents trained using simulation-based deliberate practice will show greater improvement on a standardized assessment of UGRA than residents trained using self-guided practice in simulation.…”

Development and Testing of a Curriculum for Teaching Informed Consent for Spinal Anesthesia to Anesthesiology Residents

“…We choose to have some of the residents also receive additional one-on-one faculty coaching but the study was not powered to detect if that had an independent incremental benefit and further studies may be warranted to assess this. The use of deliberate practice has been found to be an effective method for training for some skills including crisis management situations, cardiopulmonary bypass weaning, EEG interpretation, laryngoscopy, intubation and more [17]. However, this educational method is resource intensive primarily due to the cost of the expert's time.…”

Descriptive Analysis of Pharmacy Students’ Impressions on Virtual Interactive Case Software

“…Although literature is lacking in pharmacy education, incorporating a variety of simulation-based educational activities with deliberate practice is of growing interest in medical education. [6][7][8] The Virtual Interactive Case (VIC) system 9 is a web-based software (http://pie.med.utoronto.ca/vic/VIC_content/VIC_pharmacyCases.html) that allows students to practice their skills in patient encounter, information gathering and assessment. They receive built-in, real-time feedback at the end of the case based on their ability to correctly identify the patients' DTPs and create an appropriate care plan with monitoring parameters.…”

“…Am J Pharm Educ. 2012;76 (7).128. "I would recommend it because it's a nice way of prepping students prior to the hospital rotation…easier for students to transition" …”