Competency-Based Time-Variable Anesthesiology Residency Training: Identification of Problems and Solutions.

Autor:	Fuller SL; From the Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, Oregon., Ambardekar AP; Department of Anesthesiology and Pain Management, University of Texas, Southwestern Medical Center, Dallas, Texas., Diachun CAB; Department of Anesthesiology, University of Florida-Jacksonville, Jacksonville, Florida., Kearney MD; Department of Family Medicine and Community Health, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania., Long TR; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota., Miller Juve AK; From the Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, Oregon., Mitchell JD; Department of Anesthesiology, Critical Care, and Perioperative Medicine, Henry Ford Health, Detroit, Michigan., Woodworth GE; From the Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, Oregon.
Jazyk:	angličtina
Zdroj:	Anesthesia and analgesia [Anesth Analg] 2024 Apr 01; Vol. 138 (4), pp. 848-855. Date of Electronic Publication: 2023 Jul 14.
DOI:	10.1213/ANE.0000000000006625
Abstrakt:	Background: Global medical education is gradually moving toward more comprehensive implementations of a competency-based education (CBE) model. Elimination of standard time-based training and adoption of time-variable training (competency-based time-variable training [CB-TVT]) is one of the final stages of implementation of CBE. While CB-TVT has been implemented in some programs outside the United States, residency programs in the United States are still exploring this approach to training. The Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Medical Specialties (ABMS) are encouraging member boards and residency review committees to consider innovative ways programs could implement CB-TVT. The goals of this study were to (1) identify potential problems with the implementation of CB-TVT in anesthesiology residency training, (2) rank the importance of the problems and the perceived difficulty of solving them, and (3) develop proposed solutions to the identified problems. Methods: Study participants were recruited from key stakeholder groups in anesthesiology education, including current or former program directors, department chairs, residents, fellows, American Board of Anesthesiology (ABA) board members, ACGME residency review committee members or ACGME leaders, designated institutional officials, residency program coordinators, clinical operations directors, and leaders of large anesthesiology community practice groups. This study was conducted in 2 phases. In phase 1, survey questionnaires were iteratively distributed to participants to identify problems with the implementation of CB-TVT. Participants were also asked to rank the perceived importance and difficulty of each problem and to identify relevant stakeholder groups that would be responsible for solving each problem. In phase 2, surveys focused on identifying potential solutions for problems identified in phase 1. Results: A total of 36 stakeholders identified 39 potential problems, grouped into 7 major categories, with the implementation of CB-TVT in anesthesiology residency training. Of the 39 problems, 19 (48.7%) were marked as important or very important on a 5-point scale and 12 of 19 (63.2%) of the important problems were marked as difficult or very difficult to solve on a 5-point scale. Stakeholders proposed 165 total solutions to the identified problems. Conclusions: CB-TVT is a promising educational model for anesthesiology residency, which potentially results in learner flexibility, individualization of curricula, and utilization of competencies to determine learner advancement. Because of the potential problems with the implementation of CB-TVT, it is important for future pilot implementations of CB-TVT to document realized problems, efficacy of solutions, and effects on educational outcomes to justify the burden of implementing CB-TVT. Competing Interests: Conflicts of Interest: See Disclosures at the end of the article. (Copyright © 2023 International Anesthesia Research Society.)
Databáze:	MEDLINE
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