在 2019 冠状病毒病疫情期间及以后对麻醉师的教育。
Educating Anesthesiologists During the Coronavirus Disease 2019 Pandemic and Beyond.
机构信息
From the Department of Anesthesiology, The University of North Carolina, Chapel Hill, North Carolina.
Department of Anesthesiology, University of Virginia, Charlottesville, Virginia.
出版信息
Anesth Analg. 2021 Mar 1;132(3):585-593. doi: 10.1213/ANE.0000000000005333.
The coronavirus disease 2019 (COVID-19) pandemic has altered approaches to anesthesiology education by shifting educational paradigms. This vision article discusses pre-COVID-19 educational methodologies and best evidence, adaptations required under COVID-19, and evidence for these modifications, and suggests future directions for anesthesiology education. Learning management systems provide structure to online learning. They have been increasingly utilized to improve access to didactic materials asynchronously. Despite some historic reservations, the pandemic has necessitated a rapid uptake across programs. Commercially available systems offer a wide range of peer-reviewed curricular options. The flipped classroom promotes learning foundational knowledge before teaching sessions with a focus on application during structured didactics. There is growing evidence that this approach is preferred by learners and may increase knowledge gain. The flipped classroom works well with learning management systems to disseminate focused preclass work. Care must be taken to keep virtual sessions interactive. Simulation, already used in anesthesiology, has been critical in preparation for the care of COVID-19 patients. Multidisciplinary, in situ simulations allow for rapid dissemination of new team workflows. Physical distancing and reduced availability of providers have required more sessions. Early pandemic decreases in operating volumes have allowed for this; future planning will have to incorporate smaller groups, sanitizing of equipment, and attention to use of personal protective equipment. Effective technical skills training requires instruction to mastery levels, use of deliberate practice, and high-quality feedback. Reduced sizes of skill-training workshops and approaches for feedback that are not in-person will be required. Mock oral and objective structured clinical examination (OSCE) allow for training and assessment of competencies often not addressed otherwise. They provide formative and summative data and objective measurements of Accreditation Council for Graduate Medical Education (ACGME) milestones. They also allow for preparation for the American Board of Anesthesiology (ABA) APPLIED examination. Adaptations to teleconferencing or videoconferencing can allow for continued use. Benefits of teaching in this new era include enhanced availability of asynchronous learning and opportunities to apply universal, expert-driven curricula. Burdens include decreased social interactions and potential need for an increased amount of smaller, live sessions. Acquiring learning management systems and holding more frequent simulation and skills sessions with fewer learners may increase cost. With the increasing dependency on multimedia and technology support for teaching and learning, one important focus of educational research is on the development and evaluation of strategies that reduce extraneous processing and manage essential and generative processing in virtual learning environments. Collaboration to identify and implement best practices has the potential to improve education for all learners.
新型冠状病毒病 2019 (COVID-19) 大流行改变了麻醉学教育方法,改变了教育模式。本文讨论了 COVID-19 之前的教育方法和最佳证据、COVID-19 下所需的适应措施以及这些修改的证据,并为麻醉学教育提出了未来的方向。学习管理系统为在线学习提供了结构。它们已被越来越多地用于异步访问教学材料。尽管存在一些历史保留意见,但大流行迫使所有计划都迅速采用。商业上可用的系统提供了广泛的经过同行评审的课程选择。翻转课堂提倡在教学会议之前先学习基础知识,重点是在结构化教学中应用。越来越多的证据表明,这种方法受到学习者的青睐,并且可能会增加知识的获取。翻转课堂与学习管理系统配合使用,可传播重点预习作业。必须注意保持虚拟会议的互动性。模拟已经在麻醉学中使用,对于准备 COVID-19 患者的护理至关重要。多学科现场模拟允许快速传播新的团队工作流程。物理距离和提供者的可用性降低要求更多的课程。早期大流行手术量减少允许了这一点;未来的计划将不得不纳入较小的群体、设备的消毒以及对个人防护设备使用的关注。有效的技术技能培训需要掌握指令、使用刻意练习和高质量的反馈。技能培训研讨会的规模缩小以及非面对面的反馈方法都将是必需的。模拟口头和客观结构化临床考试 (OSCE) 允许培训和评估通常无法解决的能力。它们提供形成性和总结性数据以及对研究生医学教育认证委员会 (ACGME) 里程碑的客观测量。它们还允许为美国麻醉师协会 (ABA) APPLIED 考试做准备。对电话会议或视频会议的调整可以允许继续使用。在这个新时代教学的好处包括增强异步学习的可用性以及应用通用的、专家驱动的课程的机会。负担包括社交互动减少和可能需要增加更多的小规模、实时课程。获取学习管理系统并增加更频繁的模拟和技能课程,学员人数减少,可能会增加成本。随着对多媒体和技术支持的教学和学习的日益依赖,教育研究的一个重要重点是开发和评估策略,以减少虚拟学习环境中的额外处理并管理必要的和生成性的处理。合作以确定和实施最佳实践有可能改善所有学习者的教育。