Evaluation of Anesthesiology Residents’ Supervision Skills: A Tool to Assess Transition Towards Independent Practice

Abstract

Problem Anesthesiologists are often expected to supervise residents, nurse anesthetists, and anesthesiologist assistants in their practice. Development of a supervisory skill set is important during anesthesiology training and has a potential impact on the quality of patient care. During anesthesiology residency training, residents develop different competencies through direct supervision by a staff anesthesiologist. However, there is significant variability among anesthesia residency programs in the United States in terms of the opportunity residents have to supervise other anesthesia providers. The supervisory competency is not routinely evaluated during residency training. Intervention This study aimed at evaluating an educational seminar to foster the competency of supervision in anesthesiology. The 90-minute seminar included a live lecture and a series of workshops. The lecture had a duration of 45 minutes followed by three workshops of 15 minutes each. The workshops consisted of different simulated case scenarios with the participation of actors and a manikin as a patient. A debriefing session took place after the scenarios. Every resident included in the study participated in the workshops. The workshops were aligned with the learning objectives of the educational strategy. Context The study included 12 junior anesthesiology residents supervised by 24 senior residents during simulated clinical encounters. Quality of supervision, using the nine-item Quality of Supervision Questionnaire validated by De Oliveira Filho, and self-perception were evaluated before and after the educational intervention consisting of a face-to-face seminar and individual workshops administered during each encounter. Impact There was a significant difference between the overall means among senior residents for the quality of supervision measured by a nine-item quality of supervision questionnaire before and after the educational intervention program (3.11 ± 0.29 vs 3.96 ± 0.17, p < 0.01). There was no significant difference between the overall means for the self-perception of the senior residents before and after the intervention program (3.51 ± 0.54 vs. 3.48 ± 0.20). Lessons learned A bimodal educational intervention combining face-to-face seminars and workshops is effective to improve the quality of supervision in senior residents; however, it does not change the self-perception of the supervisory process. Addition of this type of educational intervention to the anesthesiology residency curriculum would add to the development of the supervisory competency and warrants further research in clinical situations.

Resident Physicians as Clinical Educators in Anesthesiology: A Narrative Review

“…Riveros Perez et al 47 described an intervention to improve senior anesthesiology residents' clinical supervision and teaching skills. The authors developed a 45-minute lecture addressing the importance and challenges of effective clinical supervision in anesthesiology, as well as three 15-minute clinical simulation modules during which 24 senior (clinical anesthesiology year-1 and -3 [CA-2 and CA-3]) anesthesiology residents supervised junior residents and received feedback on their supervision skills.…”

“…The use of anesthesiology residents as teachers in simulation scenarios was previously described. 46,47…”

Unintentional Ketamine Overdose in the Operating Room – Mixing Up the Ampules

“…Trainees should be required to demonstrate that they can safely work independently before they are responsible for a patient’s life. Research shows that enhanced clinical supervision is associated with improved clinical and educational outcomes in anesthesia 7 …”