Use of gelatin puzzle phantoms to teach medical students isolated ultrasound transducer movements and fundamental concepts.

Background: Psychomotor skills related to the use of medical ultrasound are a fundamental, but often overlooked component of this ubiquitous medical imaging technology. Although discussions of image production/orientation, sonographic planes, and imaging/scanning techniques are common in existing literature, these discussions rarely address practical skills related to these basic concepts. The cognitive load of transducer movements and machine operation, in conjunction with learning the ultrasound representation of anatomy, may overwhelm a novice learner.

An exploratory study of the relationship between postoperative nausea and vomiting and postdischarge nausea and vomiting in children undergoing ambulatory surgery.

Background: The factors contributing to postoperative nausea and vomiting in children have been identified, but there have been no reported studies that have studied pediatric postdischarge nausea and vomiting.

Aims: This preliminary study aimed to identify  the factors affecting postdischarge nausea and vomiting in ambulatory children, specifically whether postoperative nausea and vomiting factors are contributory.

Methods: One hundred and twenty-two pediatric patients aged 5-10 years undergoing elective ambulatory surgery participated in this institution-approved study.

Organization of sensory input to the nociceptive-specific cutaneous trunk muscle reflex in rat, an effective experimental system for examining nociception and plasticity.

Detailed characterization of neural circuitries furthers our understanding of how nervous systems perform specific functions and allows the use of those systems to test hypotheses. We have characterized the sensory input to the cutaneous trunk muscle (CTM; also cutaneus trunci [rat] or cutaneus maximus [mouse]) reflex (CTMR), which manifests as a puckering of the dorsal thoracolumbar skin and is selectively driven by noxious stimuli. CTM electromyography and neurogram recordings in naïve rats revealed that CTMR responses were elicited by natural stimuli and electrical stimulation of all segments from C4 to L6, a much greater extent of segmental drive to the CTMR than previously described.

Summer anesthesiology externship: Demonstrating the ability of early clinical involvement to educate and increase specialty interest.

Background: We describe the influence of a 6-week "Summer Anesthesiology Externship" featuring didactic, procedure, and simulation education on formation of medical students' specialty choice.

Methods: Eighteen months after externship completion, externs were sent a questionnaire with Likert scale agreement ratings of subspecialties/simulations and yes/no questions about student career interests before/after the program, stipend importance, and procedural skill performance during/after the program.

Results: General anesthesiology had the highest subspecialty approval rating (9.

Assessment of clinical reasoning: A Script Concordance test designed for pre-clinical medical students.

Background: The Script Concordance test (SCT) measures clinical reasoning in the context of uncertainty by comparing the responses of examinees and expert clinicians. It uses the level of agreement with a panel of experts to assign credit for the examinee's answers.

Aim: This study describes the development and validation of a SCT for pre-clinical medical students.

Intraoperative airway obstruction related to tracheostomy tube malposition in a patient with achondroplasia and Jeune's syndrome.

A 14 year-old adolescent with achondroplasia and Jeune's syndrome (asphyxiating thoracic dystrophy) presented for cervical spine surgery in the prone position. Due to the need for home mechanical ventilation at night, the patient had a tracheostomy in place. With the first surgical procedure, the cuffed tracheostomy tube was left in place during prone positioning.

Teaching systems-based competency in anesthesiology residency: development of an education and assessment tool.

Background: The Accreditation Council for Graduate Medical Education requires programs to educate and evaluate residents in 6 competencies, including systems-based practice. We designed a survey and assessment tool to address the competency as it pertains to anesthetic drug costs in an academic center.

Methods: Residents, certified registered nurse anesthetists, and faculty were asked to complete an anesthetic drug-cost survey without relying on reference materials.

Successful intraoperative spinal cord monitoring during scoliosis surgery using a total intravenous anesthetic regimen including dexmedetomidine.

Intraoperative neurophysiological monitoring (IONM) during corrective spinal surgery is widely used. Because of the possible interference with the recording of evoked potentials by inhalational anesthetics, total intravenous anesthetic (TIVA) regimens have been advocated. TIVA regimens may be difficult to use in pediatric populations due to metabolic factors.