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Background Regulators increasingly use formalized programs that are based on continuing professional development (CPD) activities to ensure that physicians are fit to practice. There is convincing evidence regarding the positive effects of CPD activities on performance and patient outcomes. However, there is limited available studies, investigating its effect in anesthesia, specifically. Moreover, although there exists considerable evidence linking specific CPD activities to improved performance, only few studies have investigated the effect of combinations of activities, or formalized systems, as a whole. Consequently, to address this uncertainty regarding the impact of CPD activities, within anesthesiology, this systematic review aims to establish which activities anesthesiologists are engaged in and their impact on clinical competence and subsequent patient outcomes. Methods A systematic review of the current literature regarding CPD for fully qualified anesthesiologists will be undertaken. Characteristics of the included studies will be summarized descriptively, and the screening process will be outlined using the preferred reporting items for systematic reviews and meta‐analysis flow diagram. Given the diverse methods adopted within medical education research, it is anticipated that there will be significant heterogeneity between the included studies and therefore, a meta‐analysis will not be possible and a narrative synthesis approach will be usd. The outcomes of interest include type of CPD learning activity and/or assessment method anesthesiologists are engaged in; and their effectiveness, either as standalone activities or as part of formalized systems. Conclusion The aim of the study was to give an overview of the breadth and nature of CPD activities, and their effects on fully qualified anesthesiologists' clinical competences and patient outcomes.

There have been numerous reports of patients initially misdiagnosed in the H1N1 and COVID-19 pandemics within the literature. A systematic review was undertaken to collate misdiagnoses during the H1N1/2009 and COVID-19 pandemics and identify which cognitive biases may contribute to this. MEDLINE, Embase, Cochrane and MedRxiv databases were searched for misdiagnoses or cognitive biases resulting in misdiagnosis, occurring during the H1N1/2009 or COVID-19 virus pandemics. Eligible studies were quality assessed using JBI criteria; primary outcome was final diagnosis. Sixty-nine studies involving 2551 participants were included. We identified 686 cases of misdiagnosis, categorised as viral respiratory infection, bacterial respiratory infection, non-respiratory infection, and non-infective. Misdiagnoses are listed and relevant investigations are offered. No article described prospective assessment of decision-making in the pandemic setting or de-biasing diagnostic thinking. Further research is required to understand why misdiagnoses occur, harm arising, and how clinicians can be assisted in their decision-making in a pandemic context.