Review article: The influence of psychology and human factors on education in anesthesiology

Abstract

Purpose We look at the changing nature of medical education in the developed world with particular reference to those areas of the new curriculum frameworks which have introduced topics from the psychosocial realm. Principle findings Research in the branch of psychology dealing with human factors has developed a useful body of working knowledge which applies to other industries where humans interact with the complex systems in which they function. Some findings are already being applied to facets of anesthesia performance, including situation awareness, effective teamwork, countermeasures against active errors and latent pathogens, and limitations of human performance. However, existing lessons and practices from industrial or military research may not translate directly into effective strategies for anesthesiologists. Collaborative studies between psychologists and clinicians should continue in order to provide the anesthetic curriculum with an effective body of knowledge for each role of the anesthesiologist. Although individual anesthesiologists have made important contributions in this field, such material has not been formally incorporated into the curricula serving anesthesiologists in the developed world. Conclusions There is a gap between the human factors psychologists now know and the human factors anesthesiologists need to know. As that gap closes, anesthesiologists may come to think more like human factor psychologists as well as biomedical scientists. RésuméObjectif Nous examinons la nature changeante de la formation me´dicale dans les pays de´veloppe´s en nous concentrant particulie`rement sur les structures des nouveaux programmes d'e´tudes qui ont inte´gre´des the`mes tire´s du monde de la psychologie. Constatations principales La recherche dans la branche de la psychologie s'inte´ressant aux facteurs humains a permis de cre´er un corpus utile de connaissances pratiques qui s'appliquent a`d'autres domaines dans lesquels l'homme interagit avec les syste`mes complexes dans lequel il e´volue. Certaines de´couvertes sont d'ores et de´jaà pplique´es a`quelques-unes des facettes de la performance en anesthe´sie, notamment la prise de conscience de la situation, l'efficacite´du travail en e´quipe, les contre-mesures pour pallier les erreurs actives et les pathoge`nes latents, et les limites de la performance humaine. Toutefois, les leçons et pratiques existantes tire´es de la recherche dans les domaines de l'industrie et de l'arme´e pourraient ne pas se traduire directement en strate´gies efficaces pour les anesthe´siologistes. Des e´tudes collaboratives re´alise´es par des psychologues et des cliniciens continuent d'eˆtre re´alise´es. Leur objectif est de fournir au programme de formation en anesthe´sie un corpus efficace de connaissances concernant chacun des rôles de l'anesthe´siologiste. Bien que certains anesthe´siologistes aient apporte´d'importantes contributions dans ce domaine, celles-ci n'ont pas e´te´inte´gre´es de façon formelle aux programmes suivis par les anesthe´siologistes dans ...

Review article: Assessment in anesthesiology education

“…Here, there are a number of potential (overlapping) frameworks that can be referenced including, amongst others, the Canadian Medical Education Directives for Specialists (CanMEDs roles) 2 and the Accreditation Council for Graduate Medical Education (ACGME) core competencies. [3][4][5] Both the CanMEDs roles and the ACGME core competencies define the abilities needed for practice. For the CanMEDs roles, the essential competencies are organized thematically around seven key physician roles: medical expert, communicator, collaborator, manager, health advocate, scholar, and professional.…”

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

“…16,20 Crisis management training and related approaches, generally described as team or non-technical skills training for high acuity events, spread rapidly across North America and Europe and now represent the bulk of anesthesia simulation-based training. 8,19,21,22 More recently, the use of simulation in anesthesia has broadened to include the acquisition of technical skills (e.g., fibreoptic oral intubations and cricothyroidotomies), [23][24][25][26] the study of performance-shaping factors and performance gaps, 27-34 the evaluation of new equipment, 35 and modelling patient flow in clinical settings. 36,37 Simulation for training: state of the science…”

“…22 Teamwork dysfunction has been associated with decreased quality of care, such as increased adverse events and poor patient outcomes. 79,80 This has led to a growing interest in collective competency, moving beyond teaching individuals alone towards also teaching team coordination and communication skills to interprofessional teams.…”

“…To understand how to provide optimal debriefing and feedback, research is needed that looks at the structure and content of debriefing and is based on decades of inquiry from cognitive and motor learning sciences. 22,114,115 Research into the effectiveness of simulation has also been directed towards the individual. More recently, however, there has been greater interest in team training and assessment of team performance.…”

“…However, it is a crucial component given that simulation requires a different form of instruction than more traditional didactic-based methods. Faculty development based on evidence and proven theories of learning 22 will be essential to ensure that we are optimizing a potentially resource intensive and expensive teaching modality.…”