Builes-Aguilar Angela, Diaz-Gomez Jose L, Bilotta Federico
Department of Anesthesia & Perioperative Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
Department of Critical Care Medicine.
Curr Opin Anaesthesiol. 2018 Oct;31(5):520-525. doi: 10.1097/ACO.0000000000000628.
We summarize the latest evidence in neuroanesthesia and neurocritical care (NCC) training. In addition, we describe the newer advancements that clinical educators face in these subspecialties. Lastly, we highlight educational approaches that may lead to an enhanced learning experience and development of necessary skills for neurosciences trainees.
Current neuroanesthesia and NCC training requires acquisition of specific skills for increasing complex surgical cases, specialized neurosurgical practice and new perioperative technologies. Furthermore, there is increasing international interest for standardization and accreditation of neuroanesthesia fellowship programs. Recent evidence has demonstrated that well structured training using high-fidelity simulation improves cognitive and technical skills in acute neurological crises.
High-fidelity simulation in perioperative care of neurosurgical patients can be part of formal neuroanesthesia and NCC curricula, and potentially impact trainees' proficiency. A research agenda is needed to validate the assessment of most effective educational interventions in neurosciences trainees with diverse medical backgrounds. Creative combinations of cost-effective interventions including traditional teaching, specific technical skills workshops, low and high-fidelity simulation deserve to be assessed in future studies.
我们总结了神经麻醉和神经重症监护（NCC）培训的最新证据。此外，我们描述了临床教育工作者在这些亚专业中面临的新进展。最后，我们强调了可能会增强神经科学 trainees 学习体验并培养必要技能的教育方法。
当前的神经麻醉和 NCC 培训需要掌握特定技能，以应对日益复杂的手术病例、专业的神经外科实践和新的围手术期技术。此外，国际上对神经麻醉专科培训项目的标准化和认证的兴趣与日俱增。最近的证据表明，使用高保真模拟进行的结构化培训可提高急性神经危机中的认知和技术技能。
神经外科患者围手术期护理中的高保真模拟可以成为正式神经麻醉和 NCC 课程的一部分，并可能影响 trainees 的熟练程度。需要一个研究议程来验证对具有不同医学背景的神经科学 trainees 最有效的教育干预措施的评估。包括传统教学、特定技术技能工作坊、低保真和高保真模拟在内的具有成本效益的干预措施的创造性组合值得在未来的研究中进行评估。
