Education in Anesthesiology: Crisis, Values and Perspectives

Main Article Content

Uría Guevara-López, PhD Manuel Víctor Terrazas Luna, MSP Eduardo Ramirez

Abstract

Background: The teaching-learning process is a fundamental competence in high-risk environments such as the operating room. Although conventional approaches are based on learning from negative performance, it is convenient to visualize the virtuous behavior of actors in specialties where security events are latent.


Objective: to explore through a survey the perception of crisis in the teaching of anesthesia in Mexico, and to identify the possible causes and precipitating factors.


Methods: A prospective observational design was used, prior approval from the research ethics committee. It was studied by means of a survey with 40 items to people who carry out their professional practice in the Mexican Republic. The positive and/or negative characteristics of specialists, student teachers, the educational program and work environment were explored.


Results: 1,125 participants responded. The highest percentage believed that there is a severe deficit in the teaching of the specialty, indicating in descending order the students, the work environment, and in similar proportions, the structure of the program and the characteristics of the teachers as the causes. Significant statistical differences were found in the attitude and values of the residents, in lack of adherence to educational programs, in the lack of stimuli, motivation and lack of recognition and encouragement to teachers, p < 0.000.


Conclusions: Our findings indicate that anesthesiologists are doing many things "right", but the existing educational deficit can be corrected to avoid an eventual crisis, suggesting a clinical practice based on evidence and values in a better environment.

Keywords: Crisis in anesthesia, working environment, educational programs, values in anesthesia

Article Details

How to Cite
GUEVARA-LÓPEZ, Uría; TERRAZAS LUNA, Manuel Víctor; RAMIREZ, Eduardo. Education in Anesthesiology: Crisis, Values and Perspectives. Medical Research Archives, [S.l.], v. 11, n. 7.2, july 2023. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/4204>. Date accessed: 23 nov. 2024. doi: https://doi.org/10.18103/mra.v11i7.2.4204.
Section
Research Articles

References

1. Fraser AB, Stodel EJ, Chaput AJ. Curriculum reform for residency training: competence, change, and opportunities for leadership. Can J Anaesth 2016; 63(7): 875-84. doi: 10.1007/s12630-016-0637-7. [PubMed: 27044399].
2. Stodel EJ, Wyand A, Crooks S, Moffett S, Chiu M, Hudson CC. Designing and Implementing a Competency Based Training Program for Anesthesiology Residents at the University of Ottawa. Anesthesiol Res Pract 2015; 713038. doi: 10.1155/2015/713038. [PubMed: 26798337]. [PubMedCentral: PMC4698531].
3. Bould MD, Naik VN, Hamstra SJ. Review article: new directions in medical education related to anesthesiology and perioperative medicine. Can J Anaesth 2012; 59(2): 136-50. doi: 10.1007/s12630-011-9633-0. [PubMed: 22161241].
4. Dabbagh A, Sezari P, Tabashi S, Tajbakhsh A, Massoudi N, Vosoghian M et al. Attitudes of Anesthesiology Residents Toward a Small Group Blended Learning Class. Anesth Pain Med 2020; 10(3). e103148. doi: 10.5812/aapm.103148. [PubMed: 32944563]. [PubMedCentral: PMC7472787].
5. Sezari P, Tajbakhsh A, Massoudi N, Arhami A, Tabashi S, Sayyadi S et al. Evaluation of one day multiple choice question workshop for anesthesiology faculty members. Anesth Pain Med 2020; 10(6). e111607. doi: 10.5812/aapm.111607.
6. He K, Whang E, Kristo G. Graduate medical education funding mechanisms, challenges, and solutions: A narrative review. Am J Surg 2021; 221(1): 65-71. doi: 10.1016/j.amjsurg.2020.06.007. [PubMed: 32680622]. [PubMedCentral: PMC7308777].
7. Stewart T, Wubbena ZC. A systematic review of service-learning in medical education: 1998-2012. Teach Learn Med 2015; 27(2): 115-22. doi: 10.1080/10401334.2015.1011647. [PubMed: 25893932].
8. Bai H. Focus: Medical Education: Modernizing Medical Education through Leadership Development. Yale J Biol Med 2020; 93(3): 433.
9. Guevara-Lopez UM. Teaching of anesthesiology. Where are we? Rev Mex Anesthesiol 2021; 44(3): 155-7. https://dx.doi.org/10.35366/9966011(3):e113606. doi: 10.5812/aapm.113606.
10. Dabbagh A, Sezari P, Tabashi S, Tajbakhsh A, Massoudi N, Vosoghian M et al. Attitudes of Anesthesiology Residents Toward a Small Group Blended Learning Class. Anesth Pain Med 2020; 10(3). e103148. doi: 10.5812/aapm.103148. [PubMed: 32944563]. [PubMed Central: PMC7472787].
11. Harbell, MW; Methangkool E. Patient safety education in anesthesia: current state and future directions. Current Opinion in Anaesthesiology; 34(6): 720-5, December 2021. |DOI: 10.1097/ACO.0000000000001060
12. Mitchell T. Adapting for the future: flexibility of UK post graduate training. Surgery (Oxf) 2020; 38(10): 670-4. doi: 10.1016/j.mpsur.2020.07.004. [PubMed: 32904590]. [PubMed Central: PMC7456398].
13. Bould MD, Naik VN, Hamstra SJ. Review article: new directions in medical education related to anesthesiology and perioperative medicine. Can J Anaesth 2012; 59(2): 136-50. doi: 10.1007/s12630-011- 9633-0. [PubMed: 22161241].
14. Guevara-López U, Altamirano-Bustamante MM, Viesca-Treviño C. New frontiers in the future of palliative care: real-world bioethical di- lemmas and axiology of clinical practice. BMC Med Ethics 2015; 16(1): 11. doi:10.1186/ s12910-015-0003-2.
15. Dabbagh A, Massoudi N, Vosoghian M, Mottaghi K, Mirkheshti A, Tajbakhsh A et al. Improving the Training Process of Anesthesiology Residents Through the Mentorship-Based Approach. Anesth Pain Med. 2019; 9(1). e88657. doi: 10.5812/aapm.88657. [PubMed: 30881915]. [PubMed Central: PMC6412912].
16. Bin Ghali KN, AlSubaie AT, Nawab AA. Mentorship in anesthesia: A perspective survey among anesthesia residents in Riyadh, Saudi Arabia. Saudi J Anaesth 2021; 15: 144‐8.
17. Dabbagh A, Elyassi H, Sabouri AS, Vahidshahi K, Ziaee SAM; Anesthesiology Department. The Role of Integrative Educational Intervention Package (Monthly ITE, Mentoring, Mocked OSCE) in Improving Successfulness for Anesthesiology Residents in the National Board Exam. Anesth Pain Med 2020; 10(2). e98566. doi: 10.5812/aapm.98566. [PubMed: 32547933]. [PubMed Central: PMC7260396].
18. Dabbagh A, Abtahi D, Aghamohammadi H, Ahmadizadeh SN, Ardehali SH. Relationship Between “Simulated Patient Scenarios and Role-Playing” Method and OSCE Performance in Senior Anesthesiology Residents: A Correlation Assessment Study. Anesth Pain Med 2020; 10(5). doi: 10.5812/aapm.106640.
19. Fadaizadeh L, Vosoughian M, Shajareh E, Dabbagh A, Heydari G. Is tele education a proper substitute for regular method to train anesthesiology residents? J Cell Mol Anesth 2019; 4(1): 15-9.
20. Etherington C et al. Identifying positive and negative use of non-technical skills by anesthesiologists in the clinical operating room: An exploratory descriptive study. Heliyon 9 (2023) e14094. https://doi.org/10.1016/j.heliyon.2023.e14094
21. Kolodzey L, Trbovich P, Kashfi A, Grantcharov TP. System factors affecting intraoperative risk and resilience: applying a novel integrated approach to study surgical performance and patient safety. Ann. Surg 2020; 272(6): 1164-70. https://doi.org/10.1097/SLA.0000000000003280.
22. Kung TH, Cheatham M, Medenilla A et al. Performance of Chat GPT on USMLE: potential for AI-assisted medical education using large language models. PLOS Digit Health 2023; 2(2): e0000198. doi: 10.1371/journal.pdig.0000198.
23. Crigger E, Reinbold K, Hanson C et al. Trust worthy augmented intelligence in health care. J Med Syst 2022; 46(12). doi:10.1007/s10916-021- 01790-z
24. Brender TD. Medicine in the era of artificial intelligence: hey chatbot, write me an H&P. JAMA Intern Med 2023. Published online April 28, 2023. doi:10.1001/jamainternmed.2023.1832
25. Dabbagh A, Gandomkar R, Farzanegan B et al. Residency Education Reform Program in Department of Anesthesiology and Critical Care: An Academic Reform Model. Anesth Pain Med 2021 Jun 9; 11(3): e113606. doi: 10.5812/aapm.113606. PMID: 34540632; PMCID: PMC8438708.
26. McInture N, Popper K. The critical attitude in medicine: the needs for a new ethics. Br Med J 1983; 287: 1919-23.