Background:Perceptual and adaptive learning modules (PALMs) are educational tools designed to enhance pattern recognition and long-term memory. We evaluated the impact of a hemodynamic monitor PALM on first-year anesthesiology residents' performance in diagnosing clinical abnormalities via waveform and vital sign interpretation on simulated monitors. Methods:First-year residents were randomly assigned to a group (n = 20) that used the hemodynamic monitor PALM or a control group (n = 21) that did not. Both groups received a pretest that measured their accuracy and fluency (percentage of responses that were both accurate and made within a target response time) in hemodynamic monitoring interpretation. The PALM group then completed the PALM and an immediate posttest within 30 minutes. The Control group only completed an immediate posttest within 30 minutes. Both groups received a delayed test after 1 month. Accuracy and fluency in diagnosing clinical abnormalities at 1 month were the primary outcomes. Results:Pretest accuracy and fluency were similar between the 2 groups. The PALM group accuracy (mean = 87% ± 3%) and fluency (mean = 64% ± 4%) were statistically significantly better than the control group accuracy (mean = 67% ± 6%, P = .001, d = 1.39) and fluency (mean = 45% ± 6%, P = .01, d = 1.11) in diagnosing clinical abnormalities at 1 month. Conclusions:Exposure to a hemodynamic monitor PALM significantly improved the accuracy and fluency in diagnosing clinical abnormalities in a group of first-year anesthesiology residents at 1 month. The hemodynamic monitor PALM can be used to enhance the interpretation of waveform abnormalities in novices.
Background:Trainees and educators spend significant effort in preparing for the anesthesiology In-Training Exam (ITE). We investigated how usage of a question bank (Qbank) among anesthesiology residents correlates to ITE performance. Methods:After gathering the number of Qbank questions completed by residents and their ITE percentile scores for 3 years, we categorized the number of questions completed by each resident each year as follows: 0-100, 101-500, 501-1000, 1001-2000, >2000. We categorized ITE score percentile for each resident each year as follows: 0-10, 11-25, 26-50, 51-75, 76-90, >90. We then performed a nonparametric regression analysis of (1) ITE score on the different categories of number of questions completed and (2) number of questions completed on the different categories of ITE score. Results:ITE scores for residents who completed >500 questions were significantly higher than for residents who completed ≤500 questions. Those who completed <100 questions averaged <30th percentile on the ITE. The number of questions completed by residents scoring >10th percentile was significantly higher than residents scoring ≤10th percentile. Residents scoring >90th percentile on the ITE completed significantly more practice questions than other residents, averaging >1000 questions. Conclusions:ITE scores were significantly different between residents who completed a low number of questions and residents who completed a high number of questions. Further work should investigate other factors that may contribute to exam performance.
Background:Anesthesiology residents have palliative care (PC) training needs given their role in perioperative medicine. Whereas anesthesiology residency programs have PC training requirements in both curricular guidelines and board certification content, little is known about the PC knowledge of anesthesiology residents. This study aimed to assess anesthesiology residents' baseline PC knowledge and perceived self-efficacy. Methods:Anesthesiology residents across 4 institutions completed a knowledge test (KT) and a self-efficacy inventory (SEI). The KT and SEI assessed 5 PC domains: pain and symptom management (PSM); communication (COMM); psychosocial, spiritual, and cultural aspects of care (PSC); terminal care and bereavement (TCB); and PC principles and practice (PCPP). Descriptive statistics were generated to assess overall resident scores and statistical tests (ANOVA for normally distributed outcomes and Kruskal-Wallis nonparametric test for nonnormal outcomes) were used to compare the scores by residency year of training. Results:On the KT, residents had the highest scores in the PSC domain, with a median (Q1, Q3) of 100% (100%, 100%), and the lowest scores in PSM, with a median (Q1,Q3) of 50% (0%, 50%). On the SEI, scored on a 4-point Likert scale, residents had the highest perceived self-efficacy in PSM (2.82±0.42) and lowest in TCB (2.55±0.55). Neither KT (p = .571) nor SEI scores (p = .203) increased with additional training with the lowest knowledge and perceived scores in the final year of training. Conclusions:This study provides exploratory insights into PC education among anesthesiology residents. By examining both resident competency and confidence, we hope to inform future educational assessment of knowledge and interventions to better prepare anesthesiology residents to incorporate PC principles into patient care.
Background:Anesthesiology rotations teach widely translatable skills and connect students with mentors in the field. However, their composition and pedagogy vary nationally, and the time available for attendings and residents to engage in intraoperative teaching is limited. Flipped classroom curricula, when applied to the operating room setting, have the potential to catalyze intraoperative teaching. Methods:We developed a flipped classroom curriculum consisting of daily modules synchronized across learner-educator teams and arranged on a perpetual calendar. The primary outcomes were learners' (ie, medical students) self-reported preparation for intraoperative teaching, appraisal of intraoperative teaching/learning quality, engagement, and critique of the curriculum. The secondary outcomes were educators' (ie, attendings and residents) assessments of intraoperative teaching/learning quality and their perception of students' preparation and engagement. A preintervention and postintervention survey design was implemented employing questions scored on 5-point Likert scales. Results:Twenty-one medical students, 41 attending educators, and 50 resident educators were enrolled during a 6-month pilot period. Preintervention and postintervention scores were compared. After the intervention, medical students more consistently came to the operating room with a defined learning goal based on self-assessment (mean [SD], 3.5 [1.1] vs 4.3 [1.0], p = .03, d = 0.6) and the assessment of educators (attending: 3.2 [0.7] vs 4.2 [0.6], p < .001, d = 1.5; resident: 3.2 [1.3] vs 4.0 [1.3], p = .02, d = 0.6). They also more consistently reviewed foundational information in preparation for teaching based on self-assessment (3.3 [1.2] vs. 4.4 [1.1], p = .006, d = 0.7) and that of educators (attending: 3.0 [0.7] vs 4.1 [0.8], p < .001, d = 1.5; resident: 3.0 [1.1] vs 3.8 [1.3], p = .05, d = 0.6). Attendings perceived that students also more consistently came to the operating room with specific questions about a topic (3.0 [1.0] vs 3.9 [0.9], p < .01, d = 1.0). Students and educators found the curriculum to be a valuable, organized, and efficient primer that promoted student engagement and higher order teaching. Conclusions:A flipped classroom curriculum can be implemented in the intraoperative arena to catalyze learners' preparation for the clinical day, set an agenda for the teaching-learning session, and promote engagement while also supporting and elevating teaching by attending and resident educators. Our synchronized format positioned on a perpetual calendar was also perceived as valuable and well-constructed.
The COVID-19 pandemic presented an unprecedented opportunity to pilot off-cycle graduate medical education (GME) entry at Oregon Health & Science University. This educational case report analyzes stakeholder perspectives on implementing an early start to residency initiative through semistructured interviews with program directors, GME operations leadership, and departmental education leaders. Three GME programs participated in the pilot: an urban academic anesthesiology program, an urban academic emergency medicine program with community rotations, and a rural community-based university-administered family medicine program. Thematic analysis of interviews conducted 9-15 months postimplementation revealed key logistical factors that facilitated or hindered implementation. Programs with flexible scheduling systems adapted more effectively, whereas those heavily dependent on resident coverage or external rotations faced greater challenges. The pilot demonstrated that staggered entry could potentially distribute novice learners throughout the year, and early start residents often emerged as peer mentors. However, programs needed to carefully manage professional identity formation and cohort integration. Whereas implementation required no direct additional costs, perceived effort of implementation varied based on program structure and setting. Drawing from educational administrative stakeholder insights across varied training settings, this report describes the administrative and structural elements observed during off-cycle GME entry, offering practical implementation guidance for interested programs.
Background:Anesthesiology has become increasingly competitive with 3172 applicants for 1992 positions in the 2025 Match. While selection is holistic, research remains a key factor. Current Match data lacks detail on research output. This study analyzes temporal, gender, and geographic trends in publication volume among medical students who matched into the top 20 US anesthesiology programs. Methods:Using Doximity's rankings, we identified the top 20 anesthesiology programs. A total of 447 residents from the 2027 graduating class and 414 from the 2024 graduating class were able to be identified through program websites. Total, first author, second author, and anesthesiology-specific publications were collected using PubMed and Google Scholar. Gender, medical school region, and residency program region were also identified for analyses. Results:Class of 2027 residents had significantly more total (2.47 vs 1.22), first author (0.57 vs 0.29), and second author (0.59 vs 0.29) publications than those from the class of 2024 (P < .01). No difference was found in anesthesiology-specific publications (P = .27). Among 2027 residents analyzed, there were significantly higher first author publications among females than males (0.72 vs 0.44, P < .01), and there were no significant differences based on medical school region. There was a significant difference in the total number and first author publications based on the region of their matched residency program (P < .001) with significantly higher total publications in New England compared with the West North Central region (P < .001). Conclusion:Research productivity increased between the graduating cohorts of 2024 and 2027, reflecting a growing emphasis on research among applicants to top anesthesiology programs. These may inform future applicants preparing for the Match.
Background:The American Medical Association's vision of precision education requires personalized, scalable learning tools. Current medical education approaches lack systems that integrate data analytics with efficient content delivery. Large language models (LLMs) are a promising approach but risk propagating misinformation without expert oversight. Methods:We developed ConsultCraft, a web-based perioperative case discussion application using the GPT-4o application program interface to reference cases developed using Claude 3.5 Sonnet with expert revision of the case narrative and learning points. Users engaged in simulated clinical case discussions designed to enhance critical thinking skills in clinical decision making. They could choose between immediate feedback (tutor mode) or deferred feedback (immersion mode). We analyzed transcripts over a 4-week period for question progression and feedback accuracy, including inferences, false credit given, and false knowledge gaps implied. Results:We analyzed 49 sessions across 9 cases with 80% in tutor mode. The LLM asked users 306 questions and generated 236 feedback responses. Analysis revealed a low rate of potentially misleading inferences (2.1%) with false credit given in 4.2% of feedback responses and false knowledge gaps implied in 9.7%. Conclusions:ConsultCraft successfully combines LLM language processing capabilities with expert content to create personalized case discussions that minimize the potential for propagating misleading information. Future directions include content mapping to certification requirements and International Classification of Diseases, 10th Revision, codes and integration with assessment and scheduling data to target gaps in knowledge and experience. This approach demonstrates how educators can leverage augmented intelligence to create tailored educational tools that preserve expert guidance while achieving the accessibility and adaptability required for precision education.
Background:High-quality feedback is essential for resident development, yet barriers to its provision persist. Artificial intelligence (AI) offers a promising tool to augment feedback, potentially addressing these challenges. This study explored whether exposing attending anesthesiologists to AI-generated feedback samples before crafting their own feedback improved its quality as rated by residents. Methods:Thirty attending anesthesiologists provided feedback on 2 vignettes addressing issues of preparedness and professionalism. Before delivering feedback on the second vignette, attendings reviewed an AI-generated feedback sample. Utilizing a validated rubric, 6 blinded residents randomly evaluated the quality of feedback across 2 conditions: attendings alone (human-only) and after attendings reviewed the AI sample (AI-augmented). Feedback ratings and vignette types were compared. Residents were assessed if they could correctly identify the origin of feedback. A qualitative analysis explored attendings' perceptions of using AI for feedback. Results:AI augmentation did not significantly improve feedback quality ratings compared with human-only feedback (p = .7). Preparedness feedback was rated higher than professionalism feedback (p = .02). Residents could not reliably distinguish the use of AI for feedback (χ 2 = .92, p = .63). Attendings reported that AI provided helpful structure and phrasing, particularly for professionalism issues, and would use it if readily available. Conclusions:Although AI augmentation did not significantly improve feedback quality, it showed promise as a tool for supporting feedback provision, particularly with crafting feedback on nontechnical, more subjective issues. Additional studies are needed to better understand AI as a tool for feedback enhancement.
Background:Opioid use, antiemetic administration, and length of postanesthesia care unit (PACU) stay are commonly documented postoperative recovery measures. The extent to which they differ across anesthesiology resident training levels independent of patient and procedural factors remains uncertain. Characterizing these patterns may help distinguish differences attributable to patient or procedural factors from those related to resident experience. Objective:To explore whether PACU recovery outcomes differ across anesthesiology resident training levels. Methods:This single-center retrospective cohort study analyzed 7699 adult nonobstetric anesthetics performed between October 2024 and May 2025, stratified by resident level (first-, second-, or third-year clinical anesthesia resident). The primary outcome was PACU morphine milligram equivalents. Secondary outcomes were rescue antiemetic use and recovery time. Univariable tests, Tukey-adjusted comparisons, and multivariable linear regressions adjusted for demographics, case characteristics, and anesthetic type. Results:Patient and case characteristics varied across resident levels. After multivariable adjustment, resident training level was not independently associated with PACU opioid use, rescue antiemetic administration, or recovery time. Unadjusted variation in these recovery measures was explained by patient and procedural factors. Conclusions:Resident training level was not an independent predictor of PACU opioid use, rescue antiemetic administration, or recovery time. Observed differences were explained by patient and procedural factors, and this highlights the complex interplay of patient comorbidities, surgical characteristics, anesthetic plans, and institutional protocols on postanesthesia recovery metrics and emphasizes the importance of case-mix adjustment when interpreting PACU outcomes in educational contexts.
Background:As anesthesiology residency becomes increasingly competitive, the transition of US Medical Licensing Examination (USMLE) Step 1 to pass/fail scoring has raised questions about the evolving role of research in applicant selection. Whereas national data suggests rising research engagement, there are limited insights into publication output among medical students applying into anesthesiology. The purpose of this study is to evaluate the relationship between the USMLE Step 1 transition and preresidency publication output of matched anesthesiology residents and to assess the role medical school National Institutes of Health (NIH) funding level has on publication metrics. Methods:This retrospective cohort study analyzed the research output of 461 anesthesiology residents across 30 programs from the classes of 2026 (numerical Step 1 scoring) and 2028 (pass/fail Step 1 scoring). Medical schools were stratified by NIH funding level to evaluate its association with research output. PubMed-indexed publications were examined using metrics including first author status, specialty relevance, citation counts, and publication types. Using Mann-Whitney U tests, group differences were compared with total publications serving as the primary outcome. Results:There were no significant differences in research output between pre- and post-Step 1 transition cohorts across all metrics. The 50th percentile in total publications was 0 for both cohorts. There was also no difference in publication output when groups were stratified by NIH funding level. Logistic regression analysis showed that high NIH funding (odds ratio 1.87, 95% confidence interval 1.21-2.89) was a significant predictor of having at least 1 publication. Conclusions:Despite increasing emphasis on research in residency applications, our findings show no significant change in publication output among anesthesiology applicants in the first class following the Step 1 transition. Whereas NIH funding level was associated with a greater likelihood of having at least 1 publication, it was not linked to higher overall publication output. This study provides a timely baseline for understanding scholarly activity in anesthesiology applicants as the residency evaluation landscape continues to evolve.
Background:Simulation-based medical education is a well-established tool for teaching technical skills to trainees. Simulation-based mastery learning (SBML) consists of pretesting, independent content review, deliberate practice, and posttesting to reach a minimum passing standard (MPS). If the MPS is not reached, the learner repeats the deliberate practice and retakes the test. SBML may be a beneficial approach for teaching regional anesthesia skills to novice residents. To implement such a curriculum, a skills assessment checklist that yields valid and reliable data must be developed for testing trainees. Methods:A checklist was developed for ultrasound-guided interscalene nerve blocks, adapted from available checklists in the literature. The checklist was designed to assess the initial knowledge and skills of novice trainees for the interscalene peripheral nerve block. This checklist was then distributed to an expert panel of regional anesthesiologists who used a modified Delphi technique to reach consensus on content. An MPS was set for the skills checklist using the Mastery Angoff standard-setting technique. Finally, the checklist was piloted; novice anesthesia residents participated in the curriculum and performed video-recorded simulated ultrasound-guided interscalene blocks before beginning their regional anesthesia rotation. Four trained raters scored videos to evaluate interrater reliability. Results:After 2 rounds, expert consensus was reached for all items; the final dichotomous checklist (correct or incorrect/not done) consisted of 19 items. The MPS was set at 18 of 19 items correct. Ten pretests and 10 posttests were reviewed by 4 raters. The average interrater reliability was Kn = 0.73. Conclusion:We developed an interscalene nerve block skills assessment checklist that was shown to produce valid and reliable data in our small pilot study. Future work will further contribute to the validity and reliability of the interscalene nerve block SBML checklist.
Background:Ultrasonography (US) provides valuable information for neuraxial procedures in patients with elevated body mass index (BMI). However, it is challenging to systematically teach US-assisted techniques to novices in clinical settings due to time constraints and patient factors. Simulator-based training may improve the learning experience while minimizing patient discomfort. Methods:With institutional review board approval, 24 learners were randomized into 2 courses, conventional (C) and experimental (E). Course C used human models for the US-assisted technique and simulators to practice intrathecal access with a spinal needle, an approach commonly used in procedural workshops. Course E used simulators that featured a 3D visualization function and incorporated the principles of deliberate practice without using human models. Results:Course C learners correctly identified an average of 74% of the sonoanatomy on a written test and marked an average of 5.8 out of 8 test targets during a lumbar sonography assessment, whereas course E learners scored 73% and marked 6.8. Ten learners in course C (83%) and 11 in course E (92%) successfully achieved dural punctures within 10 minutes on a high-BMI lumbar simulator. Additionally, 75% of course E learners followed the assessment steps before needle insertion compared with only 16.7% in course C. Conclusions:The fundamental US-assisted technique for neuraxial procedures can be effectively taught using simulator-based courses without human models. Course E, which incorporated 3D visualization and the principles of deliberate practice, was more effective in shaping stepwise approaches for the procedure.
Background:The American Board of Anesthesiology (ABA) In-Training Examination (ITE) is an annual assessment used to guide educational progress throughout residency in preparation for ABA certification examinations. Online question banks are commonly used as a study resource for these examinations; however, the relationship between question bank usage and ITE performance has not been well established. Methods:We performed a retrospective review from July 2015 to July 2023 to examine the relationship between ABA ITE performance and question bank utilization among anesthesiology residents at MaineHealth Maine Medical Center during postgraduate years (PGY) 2-4. Question bank usage was measured by evaluating the total questions answered, percentage of questions answered in tutor mode, and percentage of questions answered correctly stratified by training and calendar year. Spearman correlation was used to explore the relationship between question bank metrics and ITE score, stratified by PGY. Results:We observed significant relationships between the percentage of questions answered correctly and both ITE scaled score and national percentile ranking within each PGY. The correlation between percentage of questions answered correctly and ITE scaled score was (ρ = .49, p = .01) PGY-2, (ρ = .71, p =< .001) PGY-3, and (ρ = .48, p = .02) PGY-4. A similar trend was noted for the national percentile ranking; (ρ = .55, p = .003) PGY-2, (ρ = .71, p =< .001) PGY-3, and (ρ = .46, p = .02) PGY-4. Conclusion:The percentage of online question bank questions answered correctly by anesthesiology residents was positively associated with higher ITE scores across PGY 2-4. The percentage correct of online question banks may be used as a predictive marker for ITE performance.
Introduction:The growing responsibilities of clinician educators in academic medicine necessitates structured training opportunities during residency. However, such programs are uncommon in procedural specialties. We developed the Anesthesiology Clinician Educator Residency Track (ACE Track) at Washington University School of Medicine to bridge this gap by fostering professional identity formation and preparing residents for careers in medical education. Materials/Methods:The ACE Track is a longitudinal program integrating didactic instruction, teaching, mentorship, and educational scholarship during the fourth postgraduate year. Participants engage in coursework on educational theory, lead medical student and resident teaching sessions, and develop scholarly projects under faculty mentorship. Residents receive protected time to focus on educational initiatives, and selection is competitive based on career interest and project proposals. Results:Over 3 years, the ACE Track has enhanced participant career development, expanded educational programming, and strengthened the department's educational culture. Graduates have taken on leadership roles, developed curricula, and contributed to national education conferences. Survey data indicate increased self-perceived competency in educational skills, professional identity formation, and career clarity. Discussion:The ACE Track is a novel program that equips anesthesiology residents with foundational skills in medical education. Positive participant feedback and increasing applications suggest its value in academic career development, offering a framework for clinician-educator training in procedural fields.
Introduction:Simulation training is an essential component of transesophageal echocardiography (TEE) education, particularly for novice learners. However, a critical limitation of current mannequin-based TEE simulators is their inability to emphasize the spatial relationship between the probe's position and the resulting ultrasound images. This limitation, referred to as the "black box" effect, can make it difficult to understand how probe manipulation affects image acquisition, including probe orientation, beam trajectory, and the intersection of the ultrasound beam with cardiac structures. As a result, educators may struggle to convey these critical spatial concepts using existing simulation tools. Methods:A set of 3D-printed TEE training models was first developed to simulate the steps involved in TEE scanning procedures. They also provide beginners with an intuitive visual representation and a mental rotation process, enhancing their spatial awareness. Then, a pre-post pilot study was conducted among third-year clinical anesthesia (CA-3) residents. Three aspects of teaching quality were evaluated before and after the simulation training with 3D-printed models: TEE view-related knowledge, image quality on a mannequin-based simulator, and learners' confidence. Results:A total of 10 residents were included in this study. The knowledge assessment score significantly improved after the session (56.0 ± 22.60 vs 93.5 ± 6.26, P < .001). Image quality scores of 8 out of 12 required TEE views were also improved. Using the models positively influenced trainees' confidence in understanding and memorizing basic TEE principles: omniplane angles and corresponding TEE views [1.00 (0.75, 1.25) vs 0.00 (-1.00, 1.00), P < .01]; orientation interpretation [1.00 (1.00, 2.00) vs 0.00 (-1.00, 1.00), P < .01]. Conclusions:A simulation training session with a set of 3D-printed TEE teaching models significantly improved TEE view-related knowledge, image quality, and learners' confidence among CA-3 residents.
Background:Accurate self-assessment is critical for self-directed learning and clinical competency development. Identifying factors that influence resident's competency-based assessments is imperative to address potential disparities and foster an equitable training environment. However, studies on the relationship between demographic characteristics, such as gender and race, and self-assessment are scarce. This study aims to examine the alignment between residents' self-assessment and faculty evaluation of clinical competencies and investigate the gender- or race-related discrepancies in assessment. Methods:This retrospective study analyzed Accreditation Council for Graduate Medical Education milestone scores and self-assessments from clinical anesthesiology residents at a single site over 6 academic years (December 2015 through June 2021). Semiannual Clinical Competency Committee (CCC) assessments and resident self-assessments were compared to measure assessment alignment. Data were analyzed using mixed-effects analysis of variance and Tukey test. Results:The sample included 17 773 subcompetency ratings from 117 residents with no significant gender or race effects on CCC scores. Self-assessment scores showed a significant gender-race interaction in professionalism milestones (p = .025) with female white residents rating themselves lower than their female nonwhite (mean [95% confidence interval or CI] =14.26 [13.23, 15.30] versus 16.37 [15.15, 17.61], p = .049) and male white peers (mean [95% CI] = 14.26 [13.23, 15.30] versus 16.15 [15.41, 16.89], p = .020). Residents generally overestimated their competencies compared to CCC scores (p range: < .0001 to .702) with notable improvement in assessment alignment over time (p range: < .0001 to .002) except for interpersonal and communication skills (p = .091). White residents' medical knowledge assessment alignment was better than the nonwhite residents (mean difference, 95% CI = .22 [.03, .40], p = .027). Conclusions:Our study investigated the underexplored area of the roles gender and race play in residents' competency assessments. The findings suggest that further research is warranted to explore the impact of personal characteristics on competency assessment and to develop targeted interventions for improving competency assessment and reducing potential biases.
Background:Escape games offer an innovative approach to teaching nontechnical skills essential for managing critical events. The primary aim of this study was to assess how an analog escape box activity affected anesthesiology residents' self-efficacy with 2 nontechnical skills: establishing role clarity and using closed loop communication. Methods:In June 2024 and June 2025, a total of 38 anesthesia interns competed in teams of 4-5 to solve 5 riddles to open a locked box and take a team photo with an education program coordinator. Residents completed pretest/posttest surveys assessing their self-efficacy with establishing role clarity and using closed-loop communication and their satisfaction and perceived workload (mental/physical/temporal demand, performance workload, effort, and frustration). Changes in self-efficacy were analyzed using Wilcoxon signed-rank tests, descriptive statistics were calculated for perceived workload and satisfaction, and comments were analyzed with thematic analysis. The total cost of supplies was $325.56 for 4 escape boxes. Results:Thirty (79%) of 38 residents completed surveys. Resident self-efficacy for establishing role clarity and using closed-loop communication both increased significantly (p < .001). On a 7-point scale of perceived workload, median mental demand (4.5), temporal demand (4.5), and effort (4) were moderate, whereas physical demand (3), performance workload (2), and frustration (1.5) were low. Mean satisfaction was 3.8 out of 5. Thematic analysis of resident comments revealed teamwork and engagement as key themes. Conclusions:This study serves as a proof of concept that escape boxes are well-received and can improve residents' self-efficacy in establishing role clarity and using closed-loop communication.
Background:Ultrasound is a modern foundational tool used by anesthesiologists for peripheral nerve blocks. Clinicians performing hands-on ultrasound training on patients presents unique challenges, and the use of human anatomical donors has become a common substitute. With that, whereas ultrasound training sessions are common, they do not often include basic science anatomy reviews. This study explores an anatomist-led clinical anatomy review and physician-led ultrasound training session for first (n = 7) and second (n = 11) year anesthesiology residents. Methods:Residents attended a 2-hour anatomy review on prosected anatomical donors by anatomists prior to physicians facilitating an ultrasound-guided peripheral nerve block training session on undissected donors. The session covered the interscalene, supraclavicular, femoral, sciatic, and transversus abdominis plane ultrasound-guided peripheral nerve blocks. Data was collected using presurveys and postsurveys and assessments and analyzed. Results:The session was found to be useful and significantly improved the residents' confidence across 14 domains related to the anatomy and approach to ultrasound for the given peripheral nerve blocks. All the participants (18, 100%) felt it was very useful having undissected anatomical donors side by side to dissected ones during the session. Knowledge acquisition also improved based on the significant increase in score on the 8-question assessment (p = .003). Conclusions:The residents found this activity valuable and useful, especially learning from both undissected and prosected donors. With this approach, residents could compare the ultrasound image to the physical anatomy, which led to an increase in the residents' knowledge and confidence.
