How to train thoracic anesthesia for residents and consultants?

Abstract

Purpose of reviewThe training of anesthesiologists in thoracic surgery is a significant challenge. International professional societies usually provide only a case number-based or time-based training concept. There are only a few concepts of simulation trainings in thoracic anesthesia and interprofessional debriefings on a daily basis are rarely applied. In this review, we will show how professional curricula should aim for competence rather than number of cases and why simulation-based training and debriefing should be implemented. Recent findingsRecent curricula recommend so-called entrustable professional activities (EPAs)as a way out of the dilemma between the number of cases vs. competence. With these EPAs, competence can be mapped and prerequisites defined. Training concepts from simulation in healthcare have so far not explicitly reached anesthesia for thoracic surgery. In addition to mere technical training, combined technical-behavioral training forms have proven to be an effective training targeting the entire team in the context of the actual working environment in the operating theatre. SummaryInterdisciplinary and interprofessional learning can take place in simulation trainings and on a daily basis through postevent debriefings. When these debriefings are conducted in a structured way, an improvement in the performance of the entire team can be the result. The basis for these debriefings -as well as for other training approaches -is psychological safety, which should be established and maintained together with all professions involved.

Innovations to Improve Lung Isolation Training for Thoracic Anesthesia: A Narrative Review

“…The introduction of these helpful training methods into the curriculum for anesthesiologists in thoracic surgery is both relevant and desirable [52]. However, these methods are not yet explicitly suggested, except for TTE and TEE, in the second edition of the EACTAIC fellowship curriculum published in 2022 [53].…”

Anesthetic (r)evolution from the conventional concept to the minimally invasive techniques in thoracic surgery—narrative review

“…Based on the literature data preserving of SB can diminish the potential harmful effect of conventional approach. But it is very important to emphasise the SB during thoracic procedure can be dangerous due to unusual circumstances (i.e., paradoxical breathing, mediastinal movement) that's why the application of NIVATS in the training programs of the professional perioperative teams is essential to ensure maximal patient safety and comfort for the teams (71,72). After reviewing the literature, we identified different methods with very similar clinical results.…”