| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Correspondence |
British Columbia’s Children’s Hospital, Vancouver, Canada, E-mail: mansermino{at}cw.bc.ca
To the Editor:
We present the details of a survey of Canadian pediatric anesthesiologists conducted with the purpose of understanding current practices in supervising fellows and residents. Pediatric patients may comprise 10% to 15% of all surgical patients in Canada.1,2 Provision of anesthesia care to children is recognized to require special training and expertise.3 At present, learning objectives for the requisite three months of training in pediatric anesthesia are determined at the program level, as there is no national curriculum, nor defined competency outcomes.4
One hundred and eighty-seven Canadian pediatric anesthesiologists were invited to complete a web survey and 67 completed surveys were returned (35.1% response). For most clinical scenarios presented in the survey, a majority (50%–69%) felt it was necessary to be in the operating room even while supervising a fellow. Each case was judged independently. The respondents would be present in the operating room most often where a fellow encountered a major trauma or a known airway anomaly (Figure
). For these more complicated cases, very few (4% on average) indicated that the supervising anesthesiologist was not needed in the hospital at all. Even for uncomplicated cases outside of regular hours, in-hospital presence was viewed as unnecessary by only 19%.
|
The survey results show national variances in the level of supervision given to residents and fellows in pediatric anesthesia training programs. Future work is needed to explore attitudes behind the supervisors’ behaviour towards trainees. However, defined outcome-based competencies may be one step toward resolving discrepancies among supervisors in identifying relevant training experiences. At present, staff anesthesiologists provide trainees clinical experience while considering professional obligations and legal risks. This requires considerable discretion. A more formalized method for training fellows and residents in pediatric anesthesia would be preferable.
References
1 Hall SC. Pediatric fellowship accreditation: what have we accomplished? American Society of Anesthesiologists Newsletter [serial online] 2002 (Feb) [cited 2004 Apr 30]; 66: [1 screen]. Available from URL; http://www.asahq.org/Newsletters/2002/2_02/hall0202.htm.
2 Canadian Institute for Health Information (CIHI). Day Procedures by Province of Facility Location in 1999 [cited 2004 Apr 30]. Available from URL; http://secure.cihi.ca/cihiweb/dispPage.jsp?cw_page=statistics_a_z_e.
3 Cote CJ, Notterman DA, Karl HW, Weinberg JA, McCloskey C. Adverse sedation events in pediatrics: a critical incident analysis of contributing factors. Pediatrics 2000; 105: 805–14.
4 Royal College of Physicians and Surgeons of Canada. Objectives of training and specialty training requirements 2003 May [cited 30 April 2004]. Available from URL; http://rcpsc.medical.org/information/index.php?specialty=101&submit=Select.
5 College of Physicians and Surgeons of British Columbia. Policy manual. Guidelines to the practice of anaesthesia. As recommended by the Canadian Anaesthetists’ Society revised edition 1998 [cited 2004 Apr 30]. Available from URL; http://www.cpsbc.bc.ca/policy-manual/a/a9.htm.
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
