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J Emerg Med. 2013 Mar;44(3):676-81. doi: 10.1016/j.jemermed.2012.08.031. Epub 2012 Oct 30.

Emergency Medicine resident anesthesia training in a private vs. academic setting.

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1
Department of Surgery, Division of Emergency Medicine, University of Utah, Salt Lake City, Utah, USA.

Abstract

BACKGROUND:

Airway management is an essential part of any Emergency Medicine (EM) training program. Academic centers typically provide training to many learners at various training levels in a number of medical specialties during anesthesiology rotations. This potentially creates competition for intubation procedures that may negatively impact individual experiences.

OBJECTIVES:

We hypothesized that residents would report higher numbers of intubations and improved educational value in a private practice, rather than an academic, anesthesiology rotation.

METHODS:

EM residents' anesthesiology training was evaluated pre and post a change in training setting from an academic institution to a private practice institution. Outcome measures included the number of self-reported intubations, resident ratings of the rotation, and the number of positive comments. Residents' evaluation was measured with: a 14-item evaluation; subjective comments, which two blinded reviewers rated as positive, negative, or neutral; and transcripts from structured interviews to identify themes related to training settings.

RESULTS:

The number of intubations increased significantly in the private practice setting (4.6 intubations/day vs. 1.5 intubations/day, p < 0.001). Resident evaluations improved significantly with the private practice experience (mean scores of 3.83 vs. 2.23, p-values <0.05). Residents' impressions were also significantly higher for the private practice setting with respect to increased educational value, greater use of adjunct airway devices, and directed teaching.

CONCLUSIONS:

Number of intubations performed and residents' rating of the educational value were more favorable for a private practice anesthesiology rotation. Alternative settings may provide benefit for training in areas that have competition among trainees.

PMID:
23116930
DOI:
10.1016/j.jemermed.2012.08.031
[Indexed for MEDLINE]
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