Influence of changing work patterns on training in anaesthesia: an analysis of activity in a UK teaching hospital from 1996 to 2004 † †This article is accompanied by the Editorial.

Underwood, S.M.; McIndoe, Andrew K.

doi:10.1093/bja/aei232

Cited by 36 publications

(39 citation statements)

References 1 publication

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“…Overall, however, there has been a 27% reduction in their median number of theatre sessions (Table 1). This is similar to the 21% and 18% caseload reductions reported by two previous regional studies [12,13]. The issue for debate is whether or not the needs of senior trainees should be regarded as different from those of junior trainees and that in fact, they need more independent practice than supervised practice.…”

Section: Discussionsupporting

confidence: 84%

“…Although much of the evidence in anaesthesia supports the notion that clinical caseload has declined since the introduction of the Directive [12][13][14], Al-Rawi and Spargo have reported no reduction in caseload or proportion of supervision in their department since the Directive's implementation [15].…”

Section: This Article Is Accompanied By An Editorial See P 937 Of Tmentioning

confidence: 99%

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The effect of the European Working Time Directive on anaesthetic working patterns and training

et al. 2012

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SummaryThere is concern that the European Working Time Directive 2009 has led to reduced time available for training, and this study examined if this has been the case. For two identical six-month periods in 1999 (pre-Directive) and 2009 (postDirective), weekly data were collected on the total number of sessions attended by trainees, the number of supervised sessions and the leave days taken. A total of 5925 theatre sessions were analysed (2353 in 1999 and 3572 in 2009). For ST1-2 trainees, there was a 37% increase in theatre sessions attended (p = 0.02), with a 77% increase in the number of these sessions supervised by a consultant (p = 0.02). For ST3-7 trainees, there was a reduction in the number of theatre sessions attended of 27% (p = 0.03), but this was not accompanied by a significant increase in the number of consultantsupervised sessions (11% increase; p = 0.18). The aggregate median increase in weekly consultant-supervised theatre sessions per trainee increased for ST1-2 trainees (70% increase; p = 0.0016) but not for ST3-7 trainees (11% increase; p = 0.31). For neither trainee group did training time decline. Our data contradict the hypothesis that the European Working Time Directive has reduced access to training, or suggest that if it has, other factors (such as improved trainee rostering) have overridden its effect.

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Section: Discussionsupporting

confidence: 84%

Section: This Article Is Accompanied By An Editorial See P 937 Of Tmentioning

confidence: 99%

The effect of the European Working Time Directive on anaesthetic working patterns and training

et al. 2012

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“…Training is one thing, performance another. Concerns have been raised over a perceived increase in airway complications in UK anaesthetic practice, particularly in obstetric anaesthesia [9,14,22,23]. In the latest CEMACH report, anaesthesia-related deaths increased, and all were associated with general anaesthesia [14].…”

Section: The Problemmentioning

confidence: 99%

(Still) time to organise training in airway management in the UK

Cook

2006

Anaesthesia

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“…11 Search of the references of these studies identified another 14 citations. With further analysis, articles were selected wherein interventions relevant to one or more of the three themes were studied, resulting in a final selection of 56 citations Twenty-one studies analyzed transitions in, during, and after residency education; 19 studies addressed the educational effects of duty hour limits, [33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51] and 16 articles presented research on use of the competencies in teaching and assessing anesthesiology residents. [19][20][21][22][23][24][25][26][27][52][53][54][55][56][57][58] For the theme ''duty hours and the acquisition of competence'', the only articles included were those that assessed the effect of duty hour limits on measures of physician competence and those that studied changes in patient care experience in anesthesiology that could be attributed to the reduction in resident hours.…”

Section: Methodsmentioning

confidence: 99%

“…46,47 In one study, reduced opportunities for training with faculty and reduced perceived competence were found, 34 and no change was shown in four studies. [48][49][50][51] There is a considerable lack of high-quality studies that focus on the effect of duty hour limits on the competence of anesthesiologists after completion of training. In studies on the effect of the limits on surgical training, the hours in operative and perioperative training totalled only slightly more than 5,000 hours or somewhat more than one-fourth of the 19,200 hours in five years of surgical training with an 80-hour work week.…”

Section: Duty Hour Limits and The Acquisition Of Competencementioning

confidence: 99%

Review article: Closing the research gap at the interface of learning and clinical practice

Philibert

2011

Can J Anesth/J Can Anesth

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Purpose The dialogue at the interface of education and clinical practice highlights areas of critical importance to the development of new approaches for educating anesthesiologists. The purpose of this article is to examine the literature on education and acquisition of competence in three areas relevant to the interface of learning and clinical practice, with the aim to suggest a research agenda that adds to the evidence on preparing physicians for independent practice. The three areas are: 1) transitions across the continuum of education; 2) the effect of reductions in hours of clinical training on competence; and 3) efforts to incorporate the competencies and CanMEDS roles into teaching and evaluation. Principal findings Fifty-six articles relevant to one or more of the themes were identified in the review, including 21 studies of transitions (in, during, and after residency education), 19 studies on the effects of duty hour limits on residents' acquisition of competence, and 16 articles that assessed competency-based teaching and assessment in anesthesiology. Overall, the findings suggested a relative paucity of scientific evidence and a need for research and the development of new scientific theory. Studies generally treated one of the themes in isolation, while in actuality they interact to produce optimal as well as suboptimal learning situations, while medical education research often is limited by small samples, brief follow-up, and threats to validity. This suggests a ''research gap'' where editorials and commentaries have moved ahead of an evidence base for education. Promising areas for research include preparation for care deemed important by society, work to apply knowledge about the development of expertise in other disciplines to medicine, and ways to embed the competencies in teaching and evaluation more effectively. Conclusion Closing the research gap in medical education will require clear direction for future work. The starting point, at an institution or nationally, is dialogue within the specialty to achieve consensus on some of the most pressing questions.

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Influence of changing work patterns on training in anaesthesia: an analysis of activity in a UK teaching hospital from 1996 to 2004 † †This article is accompanied by the Editorial.

Cited by 36 publications

References 1 publication

The effect of the European Working Time Directive on anaesthetic working patterns and training

The effect of the European Working Time Directive on anaesthetic working patterns and training

(Still) time to organise training in airway management in the UK

Review article: Closing the research gap at the interface of learning and clinical practice

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