From the American Board of Anesthesiology, Raleigh, North Carolina.
Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester Minnesota.
Anesth Analg. 2021 Apr 1;132(4):1120-1128. doi: 10.1213/ANE.0000000000005316.
Anesthesiology residents' experiences and perspectives about their programs may be helpful in improving training. The goals of this repeated cross-sectional survey study are to determine: (1) the most important factors residents consider in choosing an anesthesiology residency, (2) the aspects of the clinical base year that best prepare residents for anesthesia clinical training, and what could be improved, (3) whether residents are satisfied with their anesthesiology residency and what their primary struggles are, and (4) whether residents believe their residency prepares them for proficiency in the 6 Accreditation Council for Graduate Medical Education (ACGME) Core Competencies and for independent practice.
Anesthesiologists beginning their US residency training from 2013 to 2016 were invited to participate in anonymous, confidential, and voluntary self-administered online surveys. Resident cohort was defined by clinical anesthesia year 1, such that 9 survey administrations were included in this study-3 surveys for the 2013 and 2014 cohorts (clinical anesthesia years 1-3), 2 surveys for the 2015 cohort (clinical anesthesia years 1-2), and 1 survey for the 2016 cohort (clinical anesthesia year 1).
The overall response rate was 36% (4707 responses to 12,929 invitations). On a 5-point Likert scale with 1 as "very unimportant" and 5 as "very important," quality of clinical experience (4.7-4.8 among the cohorts) and departmental commitment to education (4.3-4.5) were rated as the most important factors in anesthesiologists' choice of residency. Approximately 70% of first- and second-year residents agreed that their clinical base year prepared them well for anesthesiology residency, particularly clinical training experiences in critical care rotations, anesthesiology rotations, and surgery rotations/perioperative procedure management. Overall, residents were satisfied with their choice of anesthesiology specialty (4.4-4.5 on a 5-point scale among cohort-training levels) and their residency programs (4.0-4.1). The residency training experiences mostly met their expectations (3.8-4.0). Senior residents who reported any struggles highlighted academic more than interpersonal or technical difficulties. Senior residents generally agreed that the residency adequately prepared them for independent practice (4.1-4.4). Of the 6 ACGME Core Competencies, residents had the highest confidence in professionalism (4.7-4.9) and interpersonal and communication skills (4.6-4.8). Areas in residency that could be improved include the provision of an appropriate balance between education and service and allowance for sufficient time off to search and interview for a postresidency position.
Anesthesiology residents in the United States indicated they most value quality of clinical training experiences and are generally satisfied with their choice of specialty and residency program.
麻醉学住院医师对其项目的经验和看法可能有助于改进培训。本重复横断面调查研究的目的是确定：（1）住院医师选择麻醉学住院医师时认为最重要的因素；（2）临床基础年最能为麻醉临床培训做好准备的方面，以及可以改进的方面；（3）住院医师对麻醉住院医师的满意度以及他们的主要困难是什么；（4）住院医师是否认为他们的住院医师培训使他们能够胜任 6 项毕业后医学教育认证委员会（ACGME）核心能力，并能独立执业。
邀请 2013 年至 2016 年开始在美国接受住院医师培训的麻醉医师参加匿名、保密和自愿的在线调查。住院医师队列由临床麻醉第 1 年定义，因此本研究包括 9 次调查-2013 年和 2014 年队列（临床麻醉第 1-3 年）进行了 3 次调查，2015 年队列（临床麻醉第 1-2 年）进行了 2 次调查，2016 年队列（临床麻醉第 1 年）进行了 1 次调查。
总体回复率为 36%（4707 份对 12929 份邀请的回复）。在 5 分制的李克特量表上，1 分表示“非常不重要”，5 分表示“非常重要”，临床经验质量（各队列为 4.7-4.8）和部门对教育的承诺（4.3-4.5）被认为是麻醉医师选择住院医师的最重要因素。大约 70%的第一年和第二年住院医师认为他们的临床基础年为他们的麻醉住院医师培训做好了充分准备，特别是在重症监护轮转、麻醉轮转和手术轮转/围手术期手术管理方面的临床培训经验。总体而言，住院医师对选择麻醉专业（各培训水平队列为 4.4-4.5）和住院医师项目（4.0-4.1）感到满意。住院医师培训经历大多符合他们的期望（3.8-4.0）。报告有任何困难的高年级住院医师强调了学术上的困难，而不是人际关系或技术上的困难。高年级住院医师普遍认为住院医师培训使他们能够为独立执业做好充分准备（4.1-4.4）。在 6 项 ACGME 核心能力中，住院医师对专业精神（4.7-4.9）和人际关系与沟通技能（4.6-4.8）最有信心。住院医师培训中可以改进的方面包括在教育和服务之间提供适当的平衡，并允许有足够的时间休假以寻找和面试毕业后的职位。
美国的麻醉学住院医师表示，他们最看重临床培训经验的质量，并且对他们的专业选择和住院医师项目总体感到满意。
