Implementation of autonomy phase during the Anaesthesia and Critical Care residency: Monocentric University Hospital experience

Background: A new French curriculum about anaesthesiology and critical care residency has started in November 2017 involving an autonomy phase supervised by seniors with main objective to prepare for the professional exercise. Since 10 years, Anaesthesia and Critical Care Department of Rouen University Hospital has established a similar process with autonomy practice supervised by senior doctor during the last year of residency. Our 5th year training local program is therefore very closed from the new French anaesthesiology and intensive care residency curriculum. In our hospital, In order to project this supervised autonomy phase, the aim of this study was to assess the opinion of our former residents who benefited from our supervised autonomy phase during their last year of training.Methods: A standardized questionnaire was sent to all the residents trained in Rouen between 2004 and 2016 and who have been involved in supervised autonomy phase. Three areas were studied: the profile of responders, the practical and theoretical training received and the supervised autonomy phase.Results: The response rate was 84.1% (95/113). Theoretical and practical training was rated good or excellent for 93.7% of responders. The supervised autonomy status was noted to be positive by 94.2% of the respondents. The highlighted skills were autonomy, learning the organization of working time and preanaesthesia clinic. A majority (85%) of the residents reported having had little or no difficulty and 97% said that this status facilitated their position as a senior physician. This phase of autonomy should be included systematically in the residency for 93% of them. Conclusions: Supervised autonomy status would enable empowerment under secured supervision conditions. The majority of residents felt that this supervised autonomy phase should be systematically included in our training as proposed now by the new French curriculum.

Near Peer learning when time is limited: reflections of a junior doctor (Preprint)

UNSTRUCTURED Reflections of a junior doctor on his experience of teaching medical students during night shifts on acute medical ward cover. Student expectations were outlined during the briefing and intended learning outcomes created. A process of activated learning then ensued and after this the students were allowed a degree of supervised autonomy and independence as they conducted reviews and assessments on patients. This was fed back on positively. Key points include firstly, the importance of curriculum alignment with intended learning outcomes and secondly, an appreciation of communities of practice in medical education.