[Evaluation of further training in anesthesiology. Will we meet the demands?].

BACKGROUND

In 2009 and 2011 all German physicians authorized to provide postgraduate training (WBB) and physicians in postgraduate training (WBA) were invited to participate in a survey focusing on various aspects of postgraduate training. The survey was initiated by the German Medical Council and the contents and underlying methodology were based on a survey carried out annually in Switzerland.

RESULTS

The response rate of WBAs from 2009 and 2011 increased from 32.8 % to 38.6 % (n = 20.518) while the response rate of WBBs decreased from 60.8 % to 53.3 % (n = 9,276). Anesthesiologists (both WBB and WBA) participated more frequently compared to other disciplines (WBB 74.3 % versus 53.3 %, WBA 45.6 % versus 38.6 %). The quality of postgraduate training was evaluated on a scale from 1 to 6, with 1 as the best and 6 as the worst evaluation result. In 2009 the overall evaluation was rated as satisfying (2.54) and in 2011 there was a tendency towards improvement (2.44) with the overall result for postgraduate training quality in anesthesiology (2.44) lying exactly within the average of all disciplines. In the section critical incident management anesthesiology was assessed as being above average, whereas it was below average in the topics professional competence and decision-making culture. In terms of job situation (e.g. structure of training, off-duty after on-call duty and documentation and remuneration of overtime), anesthesiology was assessed as being above average. Although collected these data were, however, not included in the statistical analysis of the overall data set. Noteworthy was that WBBs rated the quality of postgraduate training better than WBAs (the delta being 0.66 on average over all 8 items assessed). Postgraduate training in ambulatory settings (WBS) with outpatient medical service was scored much better than average by WBAs (1.7 versus 2.44).

CONCLUSIONS

The current survey gives an insight into the assessment of over 9,000 physicians authorized to provide postgraduate training in Germany and over 20,000 physicians in training programs. While the comparison between the different medical disciplines within each survey appears to be valid the comparison between the results of the 2009 and 2011 surveys needs to be critically evaluated due to some inhomogeneities in the collectives. A higher than average participation of anesthesiologists indicates a notable willingness to contribute to measures aiming at the improvement of postgraduate training. It is difficult to assess the extent to which the data obtained in this evaluation reliably reflect the quality of postgraduate training in German medical institutions. Nevertheless, the survey provides valuable information about targeted attempts for improvement. Obvious potential for improvement can be seen not only within the scope of structural quality (training plan and target) but also in feedback. Personal contact to persons authorized to provide postgraduate training seems to have a very positive effect on the result of the evaluation. The results concerned with job situation, which were above average for anesthesiology, was not included in the evaluation performed by the German Medical Council and hence had no chance to positively influence the overall result. These results should be included in the evaluation of future surveys dealing with postgraduate training quality.