Mathis S, Schlafer O, Abram J, Kreutziger J, Paal P, Wenzel V
Univ.-Klinik für Anästhesie und Intensivmedizin, Medizinische Universität Innsbruck, Innsbruck, Österreich.
Klinik für Anästhesie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Medizin Campus Bodensee, Röntgenstr. 2, 88048, Friedrichshafen, Deutschland.
Anaesthesist. 2016 Dec;65(12):929-939. doi: 10.1007/s00101-016-0231-y.
In Germany, Austria and Switzerland, anesthesiologists are the second largest group of physicians in hospitals, but this does not correspond to the amount of anesthesiology teaching that medical students receive in medical schools. Accordingly, the chances of medical students recognizing anesthesiology as a promising personal professional career are smaller than in other disciplines with large teaching components. Subsequent difficulties to recruit anesthesiology residents are likely, although many reasons support anesthesiology as a professional career.Traditional strategies to teach medical students in anesthesiology in medical school consist of airway management or cardiopulmonary resuscitation attempts in manikins. Anesthesiology is a complex interaction consisting of anatomy, physiology, pharmacology, clinical evaluation, experience, knowledge, and manual skills. While some medical schools offer teaching in high fidelity simulators, clinical teaching in the operating room is often limited. When medical students opt for a clinical rotation in anesthesiology, there is a chance to demonstrate the fascinating world of anesthesiology, but this chance has to be utilized carefully by anesthesiologists, as young talents have to be discovered, supported, and challenged.We have put together a short guide for medical students for a clinical rotation in anesthesiology in adults in order to generate basic knowledge and interest in anesthesiology as well as a sense of achievement. Basic knowledge about premedication, induction, maintenance and strategies for anesthesia is discussed. Further, the most important anesthesia drugs are discussed and manual skills, such as intravenous cannulation, mask ventilation, intubation, and regional anesthesia are featured with QR-code based video illustrations on a smartphone or personal computer. We did not discuss possible local mannerism and special patient groups (e. g., children, special medical history), local guidelines, or standard operating procedures.Medical students can be inspired by anesthesiology when not simply told about the tools of the trade and strategies, but instead by gaining knowledge and clinical skills that render a sense of achievement, likely during a clinical rotation into anesthesiology. A short theoretical instruction of anesthesiology enables rapid and targeted orientation even before a clinical rotation. Whether this subsequently results in a higher recruiting chance is currently unknown.
在德国、奥地利和瑞士,麻醉医生是医院中第二大医生群体,但这与医学生在医学院接受的麻醉学教学量并不相符。因此,医学生将麻醉学视为有前途的个人职业选择的可能性比在其他有大量教学内容的学科中要小。尽管有许多理由支持将麻醉学作为一种职业选择,但随后招募麻醉学住院医师可能会遇到困难。
医学院校教授医学生麻醉学的传统方法包括在人体模型上进行气道管理或心肺复苏尝试。麻醉学是一个由解剖学、生理学、药理学、临床评估、经验、知识和操作技能组成的复杂相互作用。虽然一些医学院校提供高保真模拟器教学,但手术室的临床教学往往有限。当医学生选择进行麻醉学临床轮转时,有机会展示麻醉学这个迷人的领域,但麻醉医生必须谨慎利用这个机会,因为必须发现、支持和挑战年轻人才。
我们为医学生整理了一份关于成人麻醉学临床轮转的简短指南,以便让他们对麻醉学产生基础知识和兴趣以及成就感。讨论了关于术前用药、诱导、维持和麻醉策略的基础知识。此外,还讨论了最重要的麻醉药物,并通过智能手机或个人电脑上基于二维码的视频插图展示了静脉穿刺、面罩通气、插管和区域麻醉等操作技能。我们没有讨论可能的地方习惯做法和特殊患者群体(如儿童、特殊病史)、当地指南或标准操作程序。
当医学生不仅仅被告知该行业的工具和策略,而是通过获得能带来成就感的知识和临床技能时,他们可能会受到麻醉学的启发,这可能发生在麻醉学临床轮转期间。即使在临床轮转之前,简短的麻醉学理论指导也能实现快速且有针对性的定向。目前尚不清楚这随后是否会带来更高的招募几率。