Improving ACGME Compliance for Obstetric Anesthesiology Fellows Using an Automated Email Notification System

2021 ◽  
Vol 12 (03) ◽  
pp. 479-483
Author(s):  
Holly B. Ende ◽  
Michael G. Richardson ◽  
Brandon M. Lopez ◽  
Jonathan P. Wanderer
Keyword(s):  
Medical Education ◽  
Medical Record ◽  
Operating Room ◽  
Graduate Medical Education ◽  
Preoperative Evaluation ◽  
Medical Record Number ◽  
Patient Medical Record ◽  
Notification System ◽  
Exact Test ◽  
Before And After

Abstract Background The Accreditation Council for Graduate Medical Education establishes minimum case requirements for trainees. In the subspecialty of obstetric anesthesiology, requirements for fellow participation in nonobstetric antenatal procedures pose a particular challenge due to the physical location remote from labor and delivery and frequent last-minute scheduling. Objectives In response to this challenge, we implemented an informatics-based notification system, with the aim of increasing fellow participation in nonobstetric antenatal surgeries. Methods In December 2014 an automated email notification system to inform obstetric anesthesiology fellows of scheduled nonobstetric surgeries in pregnant patients was initiated. Cases were identified via daily automated query of the preoperative evaluation database looking for structured documentation of current pregnancy. Information on flagged cases including patient medical record number, operating room location, and date and time of procedure were communicated to fellows via automated email daily. Median fellow participation in nonobstetric antenatal procedures per quarter before and after implementation were compared using an exact Wilcoxon-Mann-Whitney test due to low baseline absolute counts. The fraction of antenatal cases representing nonobstetric procedures completed by fellows before and after implementation was compared using a Fisher's exact test. Results The number of nonobstetric antenatal cases logged by fellows per quarter increased significantly following implementation, from median 0[0,1] to 3[1,6] cases/quarter (p = 0.007). Additionally, nonobstetric antenatal cases completed by fellows as a percentage of total antenatal cases completed increased from 14% in preimplementation years to 52% in postimplementation years (p < 0.001). Conclusion Through an automated email system to identify nonobstetric antenatal procedures in pregnant patients, we were able to increase the number of these cases completed by fellows during 3 years following implementation.

Effect of the 80-Hour Work Week on Cases Performed by General Surgery Residents

2005 ◽  
Vol 71 (7) ◽  
pp. 552-556 ◽  
Author(s):  
Shannon Tierney Mcelearney ◽  
Alison R. Saalwachter ◽  
Traci L. Hedrick ◽  
Timothy L. Pruett ◽  
Hilary A. Sanfey ◽  
...  
Keyword(s):  
Medical Education ◽  
Operating Room ◽  
Graduate Medical Education ◽  
Surgical Training ◽  
General Surgery ◽  
Work Hours ◽  
University Hospital ◽  
Training Experience ◽  
Accreditation Council ◽  
Graduate Medical

The Accreditation Council for Graduate Medical Education (ACGME) implemented mandatory work week hours restrictions in 2003. Due to the traditionally long hours in general surgery, the effect of restrictions on surgical training and case numbers was a matter of concern. Data was compiled retrospectively from ACGME logs and operating room (OR) records at a university hospital for 2002 and 2003. Work week restrictions began in January 2003. This data was reviewed to determine resident case numbers, both in whole and by postgraduate year (PGY). Mean case numbers per resident-month in 2002 were 8.8 ± 8.2 for PGY1s, 16.2 ± 15.7 for PGY2s, 31.4 ± 12.9 for PGY3s, 31.5 ± 17.6 for PGY4s, and 31.5 ± 17.6 for PGY5s. In 2003, they were 8.8 ± 5.2 for PGY1s, 16.6 ± 13.9 for PGY2s, 27.8 ± 12.5 for PGY3s, 38.2 ± 18.8 for PGY4s, and 26.1 ± 9.6 for PGY5s. PGY1s, PGY2s, PGY3s, PGY4s, or all classes were not statistically different. PGY5s did have statistically fewer cases in 2003 ( P = 0.03). PGY5s did have statistically fewer cases after the work-hours restriction, which likely represented shifting of postcall afternoon cases to other residents. Comparing other classes and all PGYs, case numbers were not statistically different. Operative training experience does not appear to be hindered by the 80-hour work week.

scholarly journals A novel checklist for anesthesia in neurosurgical cases

2021 ◽  
Vol 12 ◽  
pp. 184
Author(s):  
Ramsis F. Ghaly ◽  
Mikhail Kushnarev ◽  
Iulia Pirvulescu ◽  
Zinaida Perciuleac ◽  
Kenneth D. Candido ◽  
...  
Keyword(s):  
Medical Education ◽  
Airway Management ◽  
Induction Period ◽  
Operating Room ◽  
Graduate Medical Education ◽  
Accreditation Council ◽  
Graduate Medical ◽  
Anesthetic Considerations ◽  
Education Requirements ◽  
Junior Residents

Throughout their training, anesthesiology residents are exposed to a variety of surgical subspecialties, many of which have specific anesthetic considerations. According to the Accreditation Council for Graduate Medical Education requirements, each anesthesiology resident must provide anesthesia for at least twenty intracerebral cases. There are several studies that demonstrate that checklists may reduce deficiencies in pre-induction room setup. We are introducing a novel checklist for neuroanesthesia, which we believe to be helpful for residents during their neuroanesthesiology rotations. Our checklist provides a quick and succinct review of neuroanesthetic challenges prior to case setup by junior residents, covering noteworthy aspects of equipment setup, airway management, induction period, intraoperative concerns, and postoperative considerations. We recommend displaying this checklist on the operating room wall for quick reference.

scholarly journals Teaching Ophthalmology Residents Clinical Optics Via a Flipped Classroom Curriculum

2019 ◽  
Vol 11 (01) ◽  
pp. e16-e21
Author(s):  
Daniel Tu ◽  
Dong-Wouk Park ◽  
Tammie Krisciunas ◽  
Thomas Hwang
Keyword(s):  
Medical Education ◽  
Graduate Medical Education ◽  
Contact Lens ◽  
Flipped Classroom ◽  
Curriculum Change ◽  
The United States ◽  
Resident Performance ◽  
Graduate Medical ◽  
Significant Difference ◽  
Before And After

Background Clinical optics is an essential part of ophthalmology resident education that can be challenging for both learners and teachers when taught using a lecture format. The effectiveness of a flipped classroom approach in this context has not been formally evaluated. Objective The main purpose of this article is to compare the effectiveness of flipped classroom versus lecture-based clinical optics curricula in a graduate medical education setting. Design Retrospective, nonrandomized, pre- and post-interventional study from 2009 to 2016. Setting, Participants Ophthalmology residency program at the Casey Eye Institute, Oregon Health & Science University, an academic medical center in the United States. Participants included all ophthalmology residents able to take at least one Ophthalmic Knowledge Assessment Program (OKAP) examination during the years 2009 to 2016. Methods The clinical optics curriculum was changed from a lecture-based series to a flipped classroom curriculum and moved from the fall to winter during the 2012 to 2013 academic year. No major changes were made to the curriculum in other subject areas during the study period. Resident performance on the OKAP annual national in-service examination for the 4 years before and after the optics curriculum change was compared. Specifically, the scaled subtest scores from the Optics, Refraction, and Contact Lens subsection were examined, while scores from the 10 nonoptics subsections served as controls. Results Scores from 57 resident test administrations before the optics curriculum change and 59 after the optic curriculum change were available for comparison. The Optics, Refraction, and Contact Lens subsection mean scores were 50.37 ± 2.31 and 57.27 ± 2.47 before and after the optics curriculum change, respectively (mean ± 95% confidence interval). This was the only subsection score to show a statistically significant difference after the optics curriculum change (p = 0.00008). Conclusions and Relevance In comparison to a lecture-based curriculum, a flipped classroom approach to clinical optics education was found to be associated with higher ophthalmology resident performance on the optics subsection of the OKAP examination. Our study suggests that a flipped classroom format may be more effective than traditional lectures for teaching clinical optics in a graduate medical education setting.

National Incidence of Medication Error in Surgical Patients Before and After Accreditation Council for Graduate Medical Education Duty-Hour Reform

2015 ◽  
Vol 72 (6) ◽  
pp. 1209-1216 ◽  
Author(s):  
Sumeet Vadera ◽  
Sandra D. Griffith ◽  
Benjamin P. Rosenbaum ◽  
Alvin Y. Chan ◽  
Nicolas R. Thompson ◽  
...  
Keyword(s):  
Medical Education ◽  
Medication Error ◽  
Graduate Medical Education ◽  
Surgical Patients ◽  
Accreditation Council ◽  
Graduate Medical ◽  
Before And After

Increased rate of complications on a neurological surgery service after implementation of the Accreditation Council for Graduate Medical Education work-hour restriction

2012 ◽  
Vol 116 (3) ◽  
pp. 483-486 ◽  
Author(s):  
Travis M. Dumont ◽  
Anand I. Rughani ◽  
Paul L. Penar ◽  
Michael A. Horgan ◽  
Bruce I. Tranmer ◽  
...  
Keyword(s):  
Medical Education ◽  
Graduate Medical Education ◽  
Mortality Rates ◽  
Morbidity And Mortality ◽  
Morbidity Rate ◽  
Accreditation Council ◽  
Graduate Medical ◽  
Before And After ◽  
Work Hour ◽  
Neurological Surgery

Object The Accreditation Council for Graduate Medical Education instituted mandatory 80-hour work-week limitations in July 2003. The work-hour restriction was met with skepticism among the academic neurosurgery community and is thought to represent a barrier to teaching, ultimately compromising patient care. The authors hypothesize that the introduction of the mandatory resident work-hour restriction corresponds with an overall increase in morbidity rate. Methods This study compares the morbidity and mortality rates on an academic neurological surgery service before and after institution of the work-hour restriction. Complications are individually assessed at a monthly divisional conference by neurosurgical faculty and residents. A prospective database was commenced in July 2000 recording all complications, complications that were deemed to be potentially avoidable (“possibly preventable”), and complications that were deemed unavoidable. The incidence of morbidity and mortality from July 2000 to June 2003 is compared with the incidence from July 2003 to June 2006. Results The overall rate of morbidity and mortality increased from 103 to 114 per 1000 patients treated after institution of the work-hour restriction, although this increase was not statistically significant (χ21, N = 8546 = 2.6, p = 0.106). The morbidity rate increased from 70 to 89 per 1000 patients treated after institution of the work-hour restriction (χ21, N = 8546 = 10, p = 0.001). The overall mortality rate was diminished from 32 to 27 per 1000 patients treated after institution of the work-hour restriction (χ21, N = 8546 = 3.2, p = 0.075). Morbidities considered avoidable or possibly preventable were seen to increase from 56 to 66 per 1000 patients treated (χ21, N = 8546 = 5.7, p = 0.017). Avoidable or possibly preventable mortalities numbered 3 per 1000 patients treated, and this rate did not change after introduction of the work-hour restriction (χ21, N = 8546 = 0.08, p = 0.777). Conclusions The morbidity rate on a neurological surgery service is increased after implementation of the work-hour restriction. Mortality rates remain unchanged.

scholarly journals Assessment of Competency in Anesthesiology

2007 ◽  
Vol 106 (4) ◽  
pp. 812-825 ◽  
Author(s):  
John E. Tetzlaff ◽  
David C. Warltier
Keyword(s):  
Medical Education ◽  
Operating Room ◽  
Graduate Medical Education ◽  
Core Competencies ◽  
Clinical Care ◽  
High Volume ◽  
Program Improvement ◽  
Classroom Teaching ◽  
Residency Programs ◽  
Graduate Medical

Assessment of competency in traditional graduate medical education has been based on observation of clinical care and classroom teaching. In anesthesiology, this has been relatively easy because of the high volume of care provided by residents under the direct observation of faculty in the operating room. With the movement to create accountability for graduate medical education, there is pressure to move toward assessment of competency. The Outcome Project of the Accreditation Council for Graduate Medical Education has mandated that residency programs teach six core competencies, create reliable tools to assess learning of the competencies, and use the data for program improvement. General approaches to assessment and how these approaches fit into the context of anesthesiology are highly relevant for academic physicians.

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