Ethical Approach to the Abusive/Disruptive Physician.

Abusive, intimidating, and disruptive behavior is unprofessional and antithetical to the provision of medical care within a culture of safety. These behaviors affect all members of the health-care team, including trainees, and have shown to result in adverse patient outcomes. When events occur, rapid intervention utilizing structured processes as required by The Joint Commission and consistent with the AMA Code of Medical Ethics needs to be implemented to protect all involved.

Physician Unionization: Opportunities and Challenges for Anesthesiologists in the United States.

Physician unionization is gaining traction in the United States, with <10% of practicing physicians now members, up from historically weak support. Factors that drive interest in unions include a decreased number of independent practitioners, an increase in workloads, and the erosion of autonomy. Approximately 56% of anesthesiologists are considered employees and may be eligible for union membership.

Management of anesthesia equipment failure: a simulation-based resident skill assessment.

Background: Intraoperative anesthesia equipment failures are a cause of anesthetic morbidity. Our purpose in this study was 1) to design a set of simulated scenarios that measure skill in managing intraoperative equipment-related errors and 2) to evaluate the reliability and validity of the measures from this multiple scenario assessment.

Methods: Eight intraoperative scenarios were created to test anesthesia residents' skills in managing a number of equipment-related failures.

Performance of residents and anesthesiologists in a simulation-based skill assessment.

Background: Anesthesiologists and anesthesia residents are expected to acquire and maintain skills to manage a wide range of acute intraoperative anesthetic events. The purpose of this study was to determine whether an inventory of simulated intraoperative scenarios provided a reliable and valid measure of anesthesia residents' and anesthesiologists' skill.

Methods: Twelve simulated acute intraoperative scenarios were designed to assess the performance of 64 residents and 35 anesthesiologists.

A simulation-based acute skills performance assessment for anesthesia training.

Unlabelled: In an earlier study, trained raters provided reliable scores for a simulation-based anesthesia acute care skill assessment. In this study, we used this acute care skill evaluation to measure the performance of student nurse anesthetists and resident physician trainees. The performance of these trainees was analyzed to provide data about acute care skill acquisition during training.

Acute care skills in anesthesia practice: a simulation-based resident performance assessment.

Background: A recurring initiative in graduate education is to find more effective methods to assess specialists' skills. Life-sized simulators could be used to assess the more complex skills expected in specialty practice if a curriculum of relevant exercises were developed that could be simply and reliably scored. The purpose of this study was to develop simulation exercises and associated scoring methods and determine whether these scenarios could be used to evaluate acute anesthesia care skills.