From the Department of Anesthesiology, Columbia University, New York, New York.
Anesth Analg. 2018 May;126(5):1687-1694. doi: 10.1213/ANE.0000000000002802.
There are many reasons for evaluating our approach and improving our teaching of America's future doctors, whether they become anesthesiologists (recruitment) or participate in patient management in the perioperative period (general patient care). Teaching medical students the seminal aspects of any medical specialty is a continual challenge. Although no definitive curricula or single clinical approach has been defined, certain key features can be ascertained from clinical experience and the literature. A survey was conducted among US anesthesiology teaching programs regarding the teaching content and approaches currently used to teach US medical students clinical anesthesia. Using the Accreditation Council for Graduate Medical Education website that lists 133 accredited anesthesiology programs, residency directors were contacted via e-mail. Based on those responses and follow-up phone calls, teaching representatives from 125 anesthesiology departments were identified and asked via e-mail to complete a survey. The survey was returned by 85 programs, yielding a response rate of 68% of individuals contacted and 63% of all departments. Ninety-one percent of the responding departments teach medical students, most in the final 2 years of medical school. Medical student exposure to clinical anesthesia occurred as elective only at 42% of the institutions, was requirement only at 16% of responding institutions, and the remainder had both elective and required courses. Anesthesiology faculty at 43% of the responding institutions reported teaching in the preclinical years of medical school, primarily in the departments of pharmacology and physiology. Forty-five percent of programs reported interdisciplinary teaching with other departments teaching classes such as gross anatomy. There is little exposure of anesthesiology faculty to medical students in other general courses. Teaching in the operating room is the primary teaching method in the clinical years. Students are allowed full access to patient care, including performing history and physical examinations, participating in the insertion of IVs and airway management. Simulation-based teaching was used by 82% of programs during medical student anesthesia clerkships. Sixty-eight percent of respondents reported that they have no formal training for their anesthesiology faculty teachers, 51% stated that they do not receive nonclinical time to teach, and 38% of respondents stated that they received some form of remuneration for teaching medical students, primarily nonclinical time. This article presents a summary of these survey results, provides a historical review of previous evaluations of teaching medical students clinical anesthesia, and discusses the contributions of anesthesiologists to medical student education.
评估我们的方法并改进我们对美国未来医生的教学有很多原因，无论他们成为麻醉师（招聘）还是参与围手术期的患者管理（一般患者护理）。教授医学生任何医学专业的基本方面都是一项持续的挑战。尽管尚未确定明确的课程或单一的临床方法，但从临床经验和文献中可以确定某些关键特征。我们对美国麻醉学教学计划进行了一项调查，了解目前用于教授美国医学生临床麻醉的教学内容和方法。使用列出 133 个认可的麻醉学计划的研究生医学教育认证委员会网站，通过电子邮件联系住院医师主任。根据这些回复和后续电话，确定了 125 个麻醉学系的教学代表，并通过电子邮件邀请他们完成调查。有 85 个计划回复了调查，回复率为联系人数的 68%和所有部门的 63%。91%的回复部门教授医学生，其中大部分在医学院的最后 2 年。在 42%的机构中，医学生只有选修临床麻醉课程，在 16%的回复机构中只有必修课程，其余机构既有选修课程也有必修课程。在 43%的回复机构中，麻醉学教师在医学生的临床前几年教授课程，主要在药理学和生理学系。45%的计划报告与其他部门进行跨学科教学，例如教授大体解剖学等课程。麻醉学教师很少在其他通识课程中接触医学生。在临床学年中，在手术室进行教学是主要的教学方法。学生可以全面参与患者护理，包括进行病史和体格检查、参与静脉注射和气道管理。82%的计划在医学生麻醉实习期间使用基于模拟的教学方法。68%的受访者表示，他们没有为麻醉学教师提供正式培训，51%表示他们没有非临床时间进行教学，38%的受访者表示他们因教授医学生而获得某种形式的报酬，主要是非临床时间。本文总结了这些调查结果，回顾了以前评估教授医学生临床麻醉的教学的历史，并讨论了麻醉师对医学生教育的贡献。
