A simulation workshop to introduce coping skills.

Background: Experiencing clinical catastrophes can result in long-lasting emotional and psychological impacts. In other fields, crisis simulation has been used to train professionals in coping skills.

Approach: Our workshop combined a simulated case with a clinical debrief and expert-led teaching on coping skills.

Mixed reality simulation for peripheral intravenous catheter placement training.

Background: Despite the advantages of simulation-based training, trainees are typically unable to view internal anatomical structures. This limitation can be overcome by using mixed reality (MR) wherein 3-D virtual anatomical images can be projected. This study was designed to evaluate the efficacy of an MR trainer for peripheral intravenous catheter (PIVC) placement.

Sequential Behavioral Analysis: A Novel Approach to Help Understand Clinical Decision-Making Patterns in Extended Reality Simulated Scenarios.

Extended reality (XR)-based simulation training offers unique features that facilitate collection of dynamic behavioral data and increased immersion/realism while providing opportunities for training health care professionals on critical events that are difficult to recreate in real life. Sequential analysis can be used to summarize learning behaviors by discovering hidden learning patterns in terms of common learning or clinical decision-making sequences. This project describes the use of sequential analysis to examine differential patterns of clinical decision-making behaviors in observed XR scenarios, allowing for new insights when using XR as a method to train for critical events and to trace clinical decision making.

American Board of Anesthesiology Mock Standardized Oral Examination Faculty Development Workshop.

Introduction: Preparation for oral board examination is an important part of residency training. Anesthesiology programs provide mock oral exams for their trainees, but often, faculty have little guidance on the conduct of these exams. We describe a faculty development workshop for anesthesiology faculty to enhance their familiarity with the American Board of Anesthesiology Standardized Oral Examination (SOE).

Virtual reality simulation for critical pediatric airway management training.

Background: Pediatric airway emergencies are relatively rare, but have potentially devastating consequences. Simulation based education is important in providing zero-risk management experience for these critical events.

Aims: The aim of the study was to assess usability and feasibility of combined interactive instructional videos and a novel Virtual Reality (VR) trainer for healthcare professionals and to evaluate the impact of this combination on learners' knowledge of critical airway events in children.

Pilot One-Hour Multidisciplinary Team Training Simulation Intervention in the Operating Room Improves Team Nontechnical Skills.

Background: The primary objective of this study was to determine if a 1-hour simulation-based training with interdisciplinary operating room (OR) teams could improve nontechnical skills of the providers as assessed by the nontechnical skills tool (NOTECHS II).

Methods: Interprofessional otolaryngology OR teams consisting of surgery faculty and resident, anesthesiology faculty and resident, and OR nurses, scrub technician, and perioperative technician underwent a 1-hour simulation-based intervention in the OR. The teams were rated on their nontechnical skills during the intervention and throughout the clinical day following.

Modules for the Technical Skills Section of the OSCE Component of the American Board of Anesthesiology APPLIED Examination.

Introduction: To assess communication and professionalism, as well as technical skills related to patient care, the American Board of Anesthesiology (ABA) has begun administering an Objective Structured Clinical Examination (OSCE) portion of the APPLIED Examination in addition to the Standard Oral Examination component.

Methods: We created video modules and a curriculum for anesthesiology resident OSCE preparation for the Interpretation of Monitors and Interpretation of Echocardiography components. The modules can be used individually by trainees or included as part of an OSCE workshop led by faculty educators with seven individual stations matching the content of the actual ABA examination.

An Analysis of the Top-cited Articles in Anesthesiology Education Literature.

Background: In the same way that impact factor is calculated for journals, the number of citations an article receives can indicate its influence or value to a particular field. This study was designed to identify the most frequently cited articles in anesthesiology education to yield insight into which articles have been most useful for researchers in ongoing research and publication.

Methods: The Web of Science database was searched to capture the top-cited articles in anesthesiology education both in anesthesiology and nonanesthesiology journals.

Mechanical strain to maxillary incisors during direct laryngoscopy.

Background: While most Direct laryngoscopy leads to dental injury in 25-39% of cases. Dental injury occurs when the forces and impacts applied to the teeth exceed the ability of the structures to dissipate energy and stress. The purpose of this study was to measure strain, (which is the change produced in the length of the tooth by a force applied to the tooth) strain rate, and strain-time integral to the maxillary incisors and determine if they varied by experience, type of blade, or use of an alcohol protective pad (APP).

Assessing anesthesiology residents' out-of-the-operating-room (OOOR) emergent airway management.

Background: At many academic institutions, anesthesiology residents are responsible for managing emergent intubations outside of the operating room (OOOR), with complications estimated to be as high as 39%. In order to create an OOOR training curriculum, we evaluated residents' familiarity with the content and correct adherence to the American Society of Anesthesiologists' Difficult Airway Algorithm (ASA DAA).

Methods: Residents completed a pre-simulation multiple-choice survey measuring their understanding and use of the DAA.

First-Person Point-of-View-Augmented Reality for Central Line Insertion Training: A Usability and Feasibility Study.

Introduction: The value of simulation in medical education and procedural skills training is well recognized. Despite this, many mannequin-based trainers are limited by the inability of the trainee to view the internal anatomical structures. This study evaluates the usability and feasibility of a first-person point-of-view-augmented reality (AR) trainer on needle insertion as a component of central venous catheter placement.

A Survey of Simulation Utilization in Anesthesiology Residency Programs in the United States.

Given the evolution of competency-based education and evidence supporting the benefits of incorporating simulation into anesthesiology residency training, simulation will likely play an important role in the training and assessment of anesthesiology residents. Currently, there are little data available regarding the current status of simulation-based curricula across US residency programs. In this study, we assessed simulation-based training and assessment in US anesthesiology programs using a survey designed to elicit information regarding the type, frequency, and content of the simulation courses offered at the 132 Accreditation Council of Graduate Medical Education-certified anesthesiology training programs.

Perioperative management of alcohol withdrawal in an achondroplastic dwarf with an unstable cervical spine: a difficult management dilemma.

Patients presenting with alcohol withdrawal syndrome have an increased risk of perioperative events related to hemodynamic and respiratory instability. We present the case of a 49-year-old achondroplastic dwarf in alcohol withdrawal with cervical spinal cord injury and aortic dissection requiring emergency surgery. Due to conflicting perioperative management goals, a decision was made to delay surgery until the patient became clinically stable.

Web-based educational activities developed by the Society for Neuroscience in Anesthesiology and Critical Care (SNACC): the experience of process, utilization, and expert evaluation.

Background: Web-based delivery of educational material by scientific societies appears to have increased recently. However, the utilization of such efforts by the members of professional societies is unknown. We report the experience with delivery of educational resources on the Web site of the Society for Neuroscience in Anesthesiology and Critical Care (SNACC), and utilization of those resources by members.

Comparison of accuracy of optic nerve ultrasound for the detection of intracranial hypertension in the setting of acutely fluctuating vs stable intracranial pressure: post-hoc analysis of data from a prospective, blinded single center study.

Introduction: Optic nerve sheath diameter (ONSD) measurement with bedside ultrasound has been shown in many studies to accurately detect high intracranial pressure (ICP). The accuracy of point-in-time ONSD measurement in the presence of ongoing fluctuation of ICP between high and normal is not known. Recent laboratory investigation suggests that reversal of optic nerve sheath distension may be impaired following bouts of intracranial hypertension.

The association between proton pump inhibitor use and outcome after aneurysmal subarachnoid hemorrhage.

Background: For many patients with aneurysmal subarachnoid hemorrhage (SAH), initiation of acid suppression therapy is concordant with guidelines and has become standard of care in neurological intensive care units. The aim of this study was to evaluate the association between type of acid suppression therapy and outcome following aneurysmal SAH.

Methods: Retrospective cohort study of consecutive aneurysmal SAH patients identified over a 5 year period.

Real-time ultrasound-guided percutaneous dilatational tracheostomy: a feasibility study.

Introduction: Ultrasound (US) performed prior to percutaneous tracheostomy (PT) may be useful in avoiding injury to pretracheal vascular structures and in avoiding high placement of the tube. Bedside real-time US guidance with visualization of needle path is routinely utilized for other procedures such as central venous catheterization, and may enhance the safety and accuracy of PT without causing airway occlusion or hypercarbia. Our objective was to demonstrate that PT performed under real-time US guidance with visualization of needle path during tracheal puncture is feasible, including in patients with features that increase the technical difficulty of PT.

Anesthesia for patients requiring advanced ventilatory support.

The critically ill patient who requires anesthesia is frequently a concern for the anesthesiologist. In addition to having potential hemodynamic lability and coagulopathy, the critically ill patient frequently experiences profound respiratory failure. The approach to the patient requiring advanced ventilatory support requires an understanding of respiratory failure, the pathophysiology causing respiratory failure and hypoxia, the physiology of mechanical ventilation and the advanced modes of ventilation available in the intensive care unit (ICU).

Acquisition of critical intraoperative event management skills in novice anesthesiology residents by using high-fidelity simulation-based training.

Background: Early acquisition of critical competencies by novice anesthesiology residents is essential for patient safety, but traditional training methods may be insufficient. The purpose of this study was to determine the effectiveness of high-fidelity simulation training of novice residents in the initial management of critical intraoperative events.

Methods: Twenty-one novice residents participated in this 6-week study.