Anesthesiology, Perioperative and Pain Medicine

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September 2013

Stanford Anesthesia Education Committee Meeting Minutes August 8, 2013

NeoSim: Dr. Hilton presented a brief summary. Approximately, 10% of newborns require some degree of resuscitation immediately after delivery. Residents on the OB anesthesia rotation attend one 4-hour session and earn Neonatal Resuscitation Provider [NRP] certification. Our program’s participation in the NeoSim program was put in place by Dr. Lipman in 2003. It is an immersive simulation program meant to be completed once during residency. Certification is good for two years and the department pays for the resident’s participation. The department will continue to financially support this important program.

MSD Libero Initiative: The new Libero program is receiving universally positive feedback. This program was designed to improve resident education in the Stanford general operating room multispecialty division (MSD) based on daily review of actual In-Training Exam keywords. All residents are invited. A topic for a talk no longer than 15 min (including questions) is chosen from this link: Available keywords are listed in black. The faculty give the same talk at 10AM, noon and 2 PM in the anesthesia conference room. Once the initial pilot is completed feedback will be taken to further improve the program. For example, attendance and results of the lectures are being tabulated for a possible consolidation of lectures from 3 to 2 per day.

New 2 week ASC Scheduling Rotation in MSD: Feedback from survey data and from town hall discussions and the annual review of program revealed need for an OR management scheduling experience. A new rotation is being piloted in the MSD. Dr. Painter presented his experience as the first resident on this rotation. The resident carries the Stanford ASC scheduling phone and runs the board and he has been well supported by the ASC staff and attendings. He learned to manage different types of staff and was provided a self-assessment tool to identify his leadership style and this involves writing a narrative of his style. The residents on this rotation attend the twice daily scheduler meeting. Dr. Painter thought this an eye-opening, great learning experience. There is also the opportunity for supervision of junior residents to help get cases started. Dr. Painter is following up with residents as they rotate through. The faculty supervisor for this resident is the Main OR scheduler.

Acupuncture Elective Curriculum: Dr. Golianu has taken over the directorship of this elective from Dr. Ratner. Dr. Golianu has rewritten the curriculum with goals and objectives for a two-week experience. The expectation for residents on any rotation is direct responsibility for patients. It will be tricky to provide more hands-on clinical work because the skills take a while to acquire. The chief residents and Dr. Golianu will coordinate the timing of this elective. Medhub evaluations of elective by resident will be reviewed at end of yr for further feedback. As with all rotations we are transitioning to the rotation specific evaluations of residents that specify and focus on the milestones appropriate for that rotation.

OB ultrasound: Dr. Carvalho discussed a new addition of ultrasound skills to the OB rotation which is now integrated in the rotation.

Chief Resident Report: The new CA1 residents are integrated and are having a smooth start with the Orientation Program. The Chief Residents will provide input to improve Orientation Program for next yr at the next education committee meeting. The new CA1 lecture start time of 3:30pm will be changed back to 4pm. All in attendance agreed.

Weekly Lecture Series: The lecture series for the CA1 class was recently revamped to accommodate the new ABA testing procedures. Senior resident Dr. Quick thought this also would be a good time to review and suggest changes to the CA2 and CA3 lecture series. After analysis it was determined that one third of lecture time was spent on administrative and wellness sessions and more faculty mentorship of journal club and case presentations is needed. The residents were polled for feedback:
1) Most residents do not want only written board prep, but rather a combination of test prep and other materials in an interactive format.
2) Change timing of practice and professional presentations to the end of the CA2 year.
3) Increase lecture series topics that are not commonly seen in the OR.
4) Use lecture time for 1-2 study halls the weeks prior to the ITE.
It was concluded that residents should be more involved in development of their own lecture series, working with Drs. Adriano and Harrison who will take these recommendations and plan changes for next year. Dr. Fanning is preparing an M&M series separate from the lecture series that would also fulfill resident educational needs. Dr. Ingrande will be invited to present plan for journal club for next year.

Generational Workshop: The Department sponsored a workshop on August 22, 2013 on “Generational Differences: How we learn, how we work”. The main learning objectives were to describe characteristics that define generational styles and differences from pre-boomers to millennials, identify two personal characteristics that define the attendees style of teaching, identify two learning styles of residents, and create list of changes in teaching practice or strategies that would bridge the gap between the two teaching/learning styles and expectations of teacher and student.

Anesthesia Knowledge Test: As of this year the AKT1 scheduled for August, and the AKT6 six mths into residency now will be practice tests only (and not reviewed by the clinical competence committee). The test results are known to the resident and faculty advisor and to be used to help assess knowledge. The ABA intraining exam is in February and the new basic ABA test for CA1s is in summer 2014.

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