Perception Precedes Reality: A Simulation and Procedural Bootcamp Improves Residents’ Comfort With Transitioning to Clinical Anesthesiology Training

Abstract

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.

Preparing interns for clinical practice through an institution-wide simulation-based mastery learning program for teaching central venous catheter placement

“…Studies have shown reduced needle passes, arterial punctures, catheter adjustments, and central line-associated bloodstream infections with SBML training in EM and IM residents. [22,23] Multiple studies have also described previous CVC training curricula, [24][25][26][27] orientation-based CVC curricula, [28][29][30] CVC curricula with SBML principles, [31,32] and an SBML orientation which included paracentesis and lumbar puncture for IM residents and medical students. [33,34] These previous efforts have focused on just-in-time education [22,23,31] or assessment of residents who traditionally performed more procedures during their training.…”

“…[33,34] These previous efforts have focused on just-in-time education [22,23,31] or assessment of residents who traditionally performed more procedures during their training. [22][23][24][25][27][28][29][30][31]33] The literature is generally void of investigations of system-wide SBML programs for establishing resident competence across an entire hospital system. While starting with wide variability in baseline performance of residents from numerous specialties, getting them all to a level of demonstrated competence was particularly important for those isolated critical care or night float rotations in which these interns may be the only provider available to perform an emergent CVC placement.…”