Anesthesiology Residents Research Articles

Perception Of Socialization In Interprofessional Practice Among Healthcare Professionals At Tertiary Healthcare Facility

Objective: To analyze the perceptions of health care professionals from a variety of fields (Anesthesia, Radiology, Gynecology, Surgery, and Orthopedics) on inter-professional socialization in a clinical setting to determine any potential disparities between educational training and to identify gaps. Method: After obtaining ethical approval and informed consent, a cross-sectional study was conducted from April to June 2023 on 150 Healthcare professionals (Residents of Anesthesiology, Radiology, Gynaecology & Obstetrics, General Surgery and Orthopedics) working at CMH/PEMH. Consecutive non-probability sampling was utilized to collect the data. A close-ended questionnaire with interprofessional socialization and valuing scale was administered to the participants, providing proper instructions through hard copy and Google Forms. Data was analyzed by using SPSS version 25. Descriptive statistics were applied. Results: Study results revealed that participants developed a recognition of the advantages of inter-professional collaboration with the highest score of valuing patient-centred care followed by self-perception of team responsibility and the lowest score of comfort in working with others. Conclusion: This research gives a unique perspective on the experiences of health science professionals from various fields (Anesthesiology, Gynecology, Orthopedics, Radiology, and Surgery) in Interprofessional socialization. Keywords: Interprofessional Socialization and Valuing Scale, Interprofessional Education, Healthcare professionals

Development and Evaluation of An In-House Lumbar Puncture Simulator for First-Year Resident Lumbar Puncture Procedure Learning.

Lumbar puncture (LP) is a common invasive technique considered an essential learning milestone for anesthesiologists due to its application in spinalanesthesia. We aimed to develop an in-house LP simulator, test its effectiveness in learning the steps to perform anLP and analyze its impact on the first-year residents' self-confidence at our hospital. We used 3D printing and silicone casting to create an LP simulator based on a lumbar spinecomputed tomography (CT). We divided 12 first-year anesthesiology residents into control and experimental groups. The control group received traditional training, while the experimental group practiced with the simulator for three months. We used a procedure checklist anda Likert scalesurvey to evaluate their procedural knowledge and self-confidence at baseline, three, and six months. Eighteen months later, we evaluated their LP performance skills. Both groups showed a significant improvement in their knowledge scores over time.After three months, the experimental group had a higher median knowledge score (10 (10 - 10) median (min-max)) than the control group (9 (8 - 9.5) median (min-max)) (p = 0.03). While there were no apparent differences in median self-confidence scores between the groups at any time point, the experimental group had a significant increase in their self-confidence for performing an unassisted LP, with a median score of 1/5 (1 - 2.3) at baseline and 5/5 (4.8 - 5) after six months (p = 0.006). In contrast, the control group's self-confidence scores decreased from 4/5 (3 - 4) after three months to 3/5 (2 - 5) after six months. The evaluation of performance skills did not yield statistically significant results. Our study demonstrates that an in-house LP simulator is an effective and practical approach for first-year anesthesiology residents to learn the LP procedure. This approach could be particularly useful in settings with limited resources and a lack of sufficient patients to practice on, as it provides an opportunity for faster learning and increased self-confidence.

A Study on Pre-clinical Anaesthesia Elective in Shaping Medical Students' Knowledge and Career Perspectives

Anesthesiology stands out as one of the rapidly growing and highly competitive medical specialties, necessitating students to cultivate an interest in anesthesia early and prepare extensively for clinical electives. Pre-clinical electives that introduce students to anesthesia and ready them for clinical settings in the early stages of their academic journey may confer benefits and enhance their competitiveness as residency applicants. This study implemented an eight-week pre-clinical elective titled "The History of Anesthesia" for first- and second-year students at Baylor College of Medicine. Eighty-eight students participated in the elective, with thirteen completing both pre-course and post-course surveys. The survey, consisting of thirteen questions related to anesthesia interest and relevant clinical knowledge, was analyzed, and statistical significance was calculated. The survey results demonstrated significantly elevated levels of self-assessed knowledge in the post-course survey compared to the pre-course survey (p < .05). Notably, topics considered more clinically relevant, such as modern anesthetic techniques, regional anesthesia, and obstetric anesthesia, exhibited significantly higher average survey results in the post-course compared to the pre-course results. The implementation of pre-clinical electives focusing on success in clinical settings appears beneficial for students aspiring to apply to an anesthesiology residency. Institutions should consider exposing students to anesthetic topics earlier in their academic journey to adequately prepare them for the competitive residency application process.

A questionnaire-based survey of perioperative utilisation of ultrasound among anaesthesiology residents

: Ultrasonography (USG) is a resourceful tool in the perioperative period. A structured training curriculum during residency can enhance the utilisation of USG among residents. : This cross-sectional online survey was conducted to evaluate the utilisation of USG in the perioperative period and to assess the adequacy of current training. : A questionnaire was formatted consisting of 15 questions. The questionnaire was sent to the participants through email or any electronic mode of communication. This was an electronic survey conducted after obtaining informed consent from the participants.: It was found that although the availability of USG has increased, its use in the perioperative period is limited due to various factors such as time constraints. The adequacy of training is significantly different depending on the frequency of training (p-value < 0.01). The majority of the residents (N=82, 81.2%) felt that they needed more training in the utilisation of USG.: Integration of a structured training curriculum in USG as a part of anaesthesiology residency can aid in enhancing patient care in the perioperative period.

A multi-residency elective to address well-being as a systems issue

What was the educational challenge? Burnout is a well-established issue in medical training, but optimal systems approaches for well-being and ways to engage residents in well-being work are unknown. What was the solution? The authors developed a multi-residency well-being elective with participants from internal medicine, anesthesiology, and urology residency programs. The elective included an asynchronous learning curriculum, a mentored independent project on system drivers of well-being, and participation in a cross-residency group that set elective priorities. How was the solution implemented? The authors worked with each residency’s leadership to protect time for participation. Concepts from Quality Improvement were used to structure the elective. Project work and resident participation were assessed continually to monitor engagement. What lessons were learned that are relevant to a wider global audience? Projects led to short- and long-term changes to support well-being in residency programs. Creating opportunities for residents from different specialties to discuss well-being work allowed ideas to spread across residencies. Protecting time to work on well-being issues may enhance a culture of well-being by demonstrating commitment to well-being as a priority equivalent to other educational endeavors. What are next steps? Further research is needed to assess the impact on resident participants and to understand how to optimally incorporate resident interventions into broader organizational strategies for well-being.

Simulation-based medical education in Canadian anesthesiology academic institutions: a national survey.

Simulation-based medical education (SBME) is provided by all anesthesiology residency programs in Canada. The purpose of this study was to characterize SBME in Canadian anesthesiology residency training programs. We administered a 21-question survey to the simulation director/coordinator for all 17 Canadian academic departments of anesthesiology from October 2019 to January 2020. The survey consisted of questions pertaining to the characteristics of the simulation centres, their faculty, learners, curriculum, and assessment processes. All 17 residency training programs participated in the survey and reported large variability in the number and formal training of simulation faculty and in content delivery. Five programs (29%) did not provide faculty recognition for curriculum design and running simulation sessions. Most programs offered one to four simulation sessions per academic year for each year of residency. All programs offered mannequin-based and part-task trainers for teaching technical and nontechnical skills. Fourteen programs (82%) offered interprofessional and interdisciplinary simulation sessions, and ten programs (59%) did not include in situ simulation training. Commonly reported barriers to faculty involvement were lack of protected time (12 programs, 71%), lack of financial compensation (ten programs, 59%), and lack of appreciation for SBME (seven programs, 41%). Large variability exists in the delivery of SBME in Canadian anesthesiology residency simulation programs, in part because of differences in financial/human resources and educational content. Future studies should explore whether training and patient outcomes differ between SBME programs and, if so, whether additional standardization is warranted.

Perceptions and Attitudes on Medical Education Extended Reality Applications from a Single Anesthesiology Residency Program

Perceptions and Attitudes on Medical Education Extended Reality Applications from a Single Anesthesiology Residency Program

Variation in Transcript Reports Among Residency Applicants: An Anesthesia Program's Perspective.

With recent changes made to move USMLE Step 1 and COMLEX Level 1 scores to Pass/Fail, it becomes necessary to find other metrics to evaluate residency candidates. One conserved metric included in all residency applications is medical school transcripts. This study aims to highlight the highly varied transcript reporting in a new era of holistic applicant review. Medical school transcripts were extracted from the Electronic Residency Application Service applications to our anesthesiology residency program for the 2021-2022 application cycle. All personally identifiable information was removed. Results were categorized and tallied by 2 independent reviewers. Overall, we assessed transcript information from 156 allopathic and osteopathic medical schools. Transcript data were separated into 9 different categories. The most common grading system for allopathic medical schools was Pass/Fail. The most common grading system for osteopathic medical schools was Pass/Fail and Letter Grades. There were several medical schools that had unique grading systems and many of those did not provide a grading key for interpretation. Less than half of the allopathic and osteopathic schools offered Honors or High Pass in their grading systems, often with little information provided as to how these grades were earned. The information provided on medical school transcripts is extremely variable. Although many schools reported grades as Pass/Fail, there was no majority or consistent presentation among the transcripts. Much of the information provided on transcripts required interpretation by its reviewer and made the process of holistic applicant review more difficult.

Bronchoscopy guided percutaneous dilatational tracheostomy; performed by anaesthesiology residents

Aims: Percutaneous dilatational tracheostomy can be performed safely at the bedside in critical patients today. Clinical studies on tracheostomy were mostly carried out by experienced healthcare professionals. This study was designed to investigate the differences of percutaneous dilatational tracheostomy performed by anaesthesiology residents using two different methods. Methods: Patients hospitalized in anaesthesia intensive care unit who underwent percutaneous tracheostomy were examined. All tracheostomy procedures were performed by anaesthesiology residents using the “Griggs” or “Ciaglia” method. The procedure time, difficulty and complications of both methods were recorded. Results: 38 patients were included in the study. It was observed that 22 of the patients had tracheostomy with the Griggs technique, and 16 with the Ciaglia technique. Tracheostomy application time was measured as 6.05 minutes with the Griggs technique and 6.35 minutes with the Ciaglia technique (p=0.939). There was no difference in complications and technical difficulties between the two methods. Conclusion: In this study, where bedside bronchoscopy guided percutaneous dilatational tracheostomies were applied by two different methods by anaesthesiology residents, no difference was found between the two methods in terms of complications and technical difficulties. We believe that "Griggs" and "Ciaglia Blue Rhino", two of the percutaneous dilatational tracheostomy methods, are not superior to each other in terms of ease of use and complications in anaesthesiology education.

Occurrence and Prevention of Substance Use Disorder Among Anaesthesiology and Intensive Care Medicine Residents in Indonesia: A Pilot Study

Background: Substance use disorders (SUD) in the population of anaesthesiology and intensive care medicine (ICM) residents have the potential to cause fatal occupational risks. Currently, there are no epidemiological reports regarding the prevalence of SUD among doctors in Indonesia and anaesthesiologists in particular. The purpose of this study was to estimate the occurrence of SUD among anaesthesiology and ICM residents in Indonesia and to recognize the SUD prevention strategy implemented in each teaching hospital. Methods: This was a survey-based observational study using a three-part questionnaire consisting of 20 binary questions, which was pertained to the sociodemographic details, the occurrence and prevention of SUD. Participants were recruited from 16 residency programs with a total of 1 127 active residents registered at the Indonesian College of Anaesthesiology and Intensive Care. All returned surveys were reviewed and scored by hand. The data were compiled and analyzed with numbers and percentages. Results: Returned surveys from 353 residents yielded a 31.3% response rate. Residents from 13 out of 16 registered residency programs in Indonesia participated in this survey. The occurrence of SUD among anaesthesiology and ICM residents in Indonesia was 0.5%. As much as 77.3% of respondents never had toxicological screening. Moreover, 18.2% of respondents were not aware of any routine toxicology screening in their program. Conclusions: The majority of anaesthesiology and ICM residents in Indonesia have risk factors for developing SUD. The need for policies, training, education, and SUD prevention strategies must be immediately addressed.

The utility of virtual reality and manikin crisis scenario simulations for anaesthesia trainee education: arandomised crossover pilot study.

Simulation education for anaesthesia trainees is essential to build clinical skills and virtual reality can provide a reproducible, high-fidelity intra-operative training environment. Compared to in-situ manikin-based simulation, this modality has yet to be thoroughly evaluated. Twenty-six second post-graduate year anaesthesiology residents were randomly divided into two groups and participated in both virtual reality and manikin crisis scenarios at sessions six months apart. The exposure order was group A virtual reality followed by manikin and group B manikin followed by virtual reality. Clinical assessments were performed using a standardised checklist. Knowledge assessments were conducted. National Aeronautics and Space Administration Task Load Index and System Usability Scale scores were collected immediately after participation. Clinical scores between groups A and B were not significantly different. Group A had improved post-simulation knowledge scores after both sessions. Task load index scores were lower in mental demand for virtual reality. System usability scores showed less ease of use and more need for support in virtual reality.

The Impact of an Interactive Unconscious Bias Training on Perioperative Learners.

Providers' unconscious biases reinforce health disparities through negative direct patient care and interactions with colleagues. We created a workshop grounded in Critical Race Theory and the importance of different intersectionalities to improve medical trainees' self-assessment of their implicit biases in curated facilitated spaces. A total of 44 UCSF first-year clinical anesthesiology residents (CA-1) (95% response rate) and 23 surgery residents in their research year (77% response rate) participated in this workshop over 4 separate sessions in September 2020 and 2021. Quantitative data from a pre-/post-workshop survey was analyzed via a paired t test to evaluate our workshop's effectiveness. Feedback on efficacy was obtained by coding themes from our survey's open-ended questions. The workshop was evaluated positively by a total of 65 of 67 participants in the post-workshop survey. On a 5-point Likert scale, participants self-reported they agreed that their unconscious biases affect their clinical interactions from a pre-workshop mean of 3.3 (SD ± 1.32) to a post-workshop mean of 3.9 (SD ± 0.87, P = .008). Our findings suggest that this workshop was effective for perioperative residents and can be extrapolated to all residents by tailoring the workshop to their respective work environments.

Women Anesthesiologists in Sub-Saharan Africa in the Pre-COVID Era: A Multinational Demographic Study.

Gender imbalance and poor representation of women complicate the anesthesiology workforce crisis in sub-Saharan Africa (SSA). This study was performed to obtain a better understanding of gender disparity among medical graduates and anesthesiologists in SSA. Using a quantitative, participatory, insider research study, led by female anesthesiologists as the national coordinators in SSA, we collected data from academic or national health authorities and agencies. National coordinators were nominees of anesthesiology societies that responded to our email invitations. Data gathered from 13 countries included information on medical graduates, anesthesiologists graduating between 1998 and 2021, and number of anesthesiologists licensed to practice in 2018. We compared data between Francophone and Anglophone countries, and between countries in East Africa and West Africa/Central Africa. We calculated anesthesiology workforce densities and compared representation of women among graduating anesthesiologists and medical graduates.Data analysis was performed using linear regression. We used F-tests on regression slopes to assess the trends in representation of women over the years and the differences between the slopes. A value of P < .050 was considered statistically significant. Over a 20-year period, the representation of female medical graduates in SSA increased from 29% (1998) to 41% (2017), whereas representation of female anesthesiologists was inconsistent, with an average of 25%, and lagged behind. Growth and gender disparity patterns were different between West Africa/Central Africa and East Africa. Representation of female anesthesiologists was higher in East Africa (39.4%) than West Africa/Central Africa (19.7%); and the representation of female medical graduates in East Africa (42.5%) was also higher that West Africa/Central Africa (33.1%). On average, in SSA, female medical graduates (36.9%), female anesthesiologists (24.9%), and female anesthesiology residents projected to graduate between 2018 and 2022 (25.2%) were underrepresented when compared to their male counterparts. Women were underrepresented in SSA, despite evidence that their representation in medicine and anesthesiology in East African countries was rising.

Palpation Versus Ultrasonography for Identifying the Cricothyroid Membrane in Case of a Laterally Deviated Larynx: A Randomized Trial.

Large neck circumference and displacement of the trachea due to pathology increase the risk of failed identification of the cricothyroid membrane and cricothyroidotomy. We investigated whether ultrasound aids in the successful identification of the cricothyroid membrane in a model of an obese neck with midline deviation of the trachea. We developed silicone neck models that were suitable for both palpation and ultrasonography and where the trachea deviated laterally from the midline to either side. After reading a book chapter and participating in a 25-minute lecture and a 15- to 23-minute hands-on demonstration and rehearsal of ultrasonography for identification of the cricothyroid membrane, anesthesiologists and anesthesiology residents randomly performed identification with either ultrasound or palpation on 1 of 2 neck models. We included 57 participants, of whom 29 and 28 were randomized to palpation and ultrasound, respectively. Correct identification of the cricothyroid membrane was achieved by 21 (75.0%) vs 1 (3.5%) of participants in the ultrasound versus palpation groups (risk ratio [RR], 21.8 [95% confidence interval {CI}, 3.1-151.0]). The tracheal midline position in the sagittal plane was identified correctly by 24 (85.7%) vs 16 (55.2%) of participants in the ultrasound versus palpation groups (RR, 1.6 [95% CI, 1.1-2.2]). Identification of the cricothyroid membrane in a model of an obese neck with midline deviation of the trachea was more often successful with ultrasound compared to palpation. Our study supports the potential use of ultrasound before induction of anesthesia and airway management in this group of patients, and it may even be applied in emergency situations when ultrasound is readily available. Further studies in human subjects should be conducted.

Relationship between Misconduct of Medical Professionalism with Burnout Syndrome and Related Factors

Background: Burnout syndrome (BOS) is a common occupational disease amongst medical physicians; especially anesthesiologists. BOS is known to result in increased expenditure of the healthcare system and decreased patient satisfaction. In order to substitute for good conduct by its medical staff, Tehran University of Medical University established its own guidelines on professionalism as a substitute for professional conduct amongst its personnel. Learning and practicing professionalism is not only a requirement to be competent as a specialist, but also it results in increasing healthcare quality and patient satisfaction. There is a lack of studies on the relationship between BOS and professionalism.&#x0D; Determination of the relationships between professionalism and BOS among TUMS anesthesiology residents.&#x0D; Methods: In this cross-sectional study all anesthesiology residents completed three forms (demographic checklist, Maslach Burnout Inventory (MBI), and professionalism self-conduct). The results were primarily analyzed using STATA 14.0 and relationships were established via linear and binary regression.&#x0D; Results: About 44 percent of residents met criteria for BOS. The risk of developing BOS was significantly higher for residents who adhered to the principles of respect and altruism and for residents training in one of our surveyed hospitals; whereas the risk of developing BOS would be reduced by increasing age and adherence to the principles of justice Burnout subscales scores concerning emotional exhaustion and personal accomplishment were significantly related with higher self-reported scores of altruism and honesty-integrity respectively.&#x0D; Conclusion: The chances of developing BOS could be enhanced by inadequate practice in the field of professional ethics. Therefor the importance of learning and competent practice of professionalism must be acknowledged. Age and professional climate were the most important demographic variables related to BOS in anesthesiology residents

Where have all the pediatric anesthesiology fellows gone in the USA? Anesthesiology fellowship trends.

Recent consternation over the number of unfilled Pediatric Anesthesiology fellowship positions in the United States compelled us to assess the change in the ratio of Pediatric Anesthesiology fellows to the number of graduating anesthesiology residents over the 14-year period between 2008 and 2022. We also sought to report the total ratio of anesthesiology fellows to graduating residents and trends in the annual number of fellowship applicants relative to the number of Accreditation Council for Graduate Medical Education (ACGME)-accredited anesthesiology fellowship positions by specialty. We used publicly available resources, including ACGME Data Resource Books, National Resident Matching Program (NRMP) data, San Francisco (SF) Match data, and American Board of Medical Specialties (ABMS) data, to determine the ratio of anesthesiology fellows to graduating anesthesiology residents and to compare the number of fellowship applicants to fellowship positions for Adult Cardiothoracic Anesthesiology, Critical Care Anesthesiology, Obstetric Anesthesiology, Pain Medicine and Pediatric Anesthesiology. Since 2008, the ratio of ACGME-accredited anesthesiology fellows to graduating residents increased from 0.36 in 2008 (2007 residency graduates) to 0.59 in 2022 (2021 residency graduates) and the ratio of Pediatric Anesthesiology fellows to graduating residents remained relatively stable from 0.10 to 0.11. The number of unmatched positions in Pediatric Anesthesiology increased from 17 in 2017 to 86 in 2023, and all ACGME-accredited fellowships had more positions available than applicants in 2023. In the USA, while the ratio of Pediatric Anesthesiology fellowship graduates to anesthesiology residency graduates remained relatively constant from 2008 to 2022, this is likely a lagging indicator that has not yet accounted for the recent decrease in fellowship applicants. These findings refute prior estimates for a surplus in Pediatric Anesthesia supply in the USA and have significant implications for the future.

A deployable curriculum with 3D printed skills trainers for altered airway management

BackgroundAltered Airway Anatomy (AAA), including tracheostomies and laryngectomies, may represent an area of unease for non-Otolaryngology trainees, due to a lack of exposure, structured education, or dedicated training in altered airway management. Inability to effectively stabilize an altered airway is associated with significant risk of patient morbidity and mortality. This study aims to assess the efficacy of a concise curriculum using three-dimensional (3D) printed airway models for skill training in improving Anesthesiology trainees’ competency in AAA management.MethodsA prospective cohort of 42 anesthesiology residents at a tertiary care institution were guided through a 75-min curriculum on AAA, including case discussion, surgical video, and hands-on practice with tracheostomy and laryngectomy skills trainers. Pre- and post- course surveys assessing provider confidence (Likert scale) and knowledge (multiple choice questions) were administered. Additionally, an observed skills competency assessment was performed.ResultsSelf-perceived confidence improved from a summative score across all domains of 23.65/40 pre-course to 36.39/40 post-course (n = 31, p < 0.001). Technical knowledge on multiple choice questions improved from 71 to 95% (n = 29, p < 0.001). In the completed skills competency assessment, 42/42 residents completed 5/5 assessed tasks successfully, demonstrating objective skills-based competency.ConclusionsThis study demonstrates an improvement in anesthesiology resident self-assessed confidence, objective knowledge, and skills based competency surrounding management of patients with AAA following a 75-min simulation-based curriculum.

Evaluating pre-anesthesia assessment performance in residency: the reliability of standardized patient methods.

Pre-anesthesia assessment clinic (PAC) is known to increase safety and quality in the perioperative period. However, PAC teaching during anesthesiology residency is a challenge. The objective of this study was to assess the reliability of a simulation score grid using a standardized patient on the PAC performance of anesthesiology residents. A score grid, including the 4 components of the PAC (clinical evaluation, perioperative strategy, information and communication) was validated by a group of 5 senior anesthesiologists. Anesthesiology residents (> one year) and attending anesthesiologists were included. The same simulation sequence with the same standardized patient was conducted in a simulation dedicated consultation room. The simulation sequence was followed by a debriefing session with the 2 professors (anesthesiology and communication) and each anesthesiology resident. The main outcome was the overall grid score out of a maximum score of 300 and the correlation of this score with experience in anesthesiology residency. Secondary outcomes were individual component scores according to level of experience in anesthesiology. Between October 2014 and April 2016, 109 anesthesiology residents and 16 attending anesthesiologists were included in this prospective bicentric study. There was a positive correlation (p < 0.01) between level of experience and overall score on the grid score (Pearson's Coefficient = 0.52). The Pearson correlation coefficient between overall assessment and level of experience in anesthesiology was 0.46 (p < 0.01). The analysis of the sub-scores for the 4 components of the overall score (evaluation, perioperative strategy, information and communication) also identify differences between groups of experience. Standardized patient Simulation of PAC seems to be a reliable tool to assess PAC performance in anesthesiology residents and senior anesthesiologists. These results suggest standardized patient simulation could be used as a teaching tool for PAC.

Validating Parallel-Forms Tests for Assessing Anesthesia Resident Knowledge.

We created a serious game to teach first year anesthesiology (CA-1) residents to perform general anesthesia for cesarean delivery. We aimed to investigate resident knowledge gains after playing the game and having received one of 2 modalities of debriefing. We report on the development and validation of scores from parallel test forms for criterion-referenced interpretations of resident knowledge. The test forms were intended for use as pre- and posttests for the experiment. Validation of instruments measuring the study's primary outcome was considered essential for adding rigor to the planned experiment, to be able to trust the study's results. Parallel, multiple-choice test forms development steps included: (1) assessment purpose and population specification; (2) content domain specification and writing/selection of items; (3) content validation by experts of paired items by topic and cognitive level; and (4) empirical validation of scores from the parallel test forms using Classical Test Theory (CTT) techniques. Field testing involved online administration of 52 shuffled items from both test forms to 24 CA-1's, 21 second-year anesthesiology (CA-2) residents, 2 fellows, 1 attending anesthesiologist, and 1 of unknown rank at 3 US institutions. Items from each form yielded near-normal score distributions, with similar medians, ranges, and standard deviations. Evaluations of CTT item difficulty (item p values) and discrimination (D) indices indicated that most items met assumptions of criterion-referenced test design, separating experienced from novice residents. Experienced residents performed better on overall domain scores than novices (P < .05). Kuder-Richardson Formula 20 (KR-20) reliability estimates of both test forms were above the acceptability cut of .70, and parallel forms reliability estimate was high at .86, indicating results were consistent with theoretical expectations. Total scores of parallel test forms demonstrated item-level validity, strong internal consistency and parallel forms reliability, suggesting sufficient robustness for knowledge outcomes assessments of CA-1 residents.

Perioperative use of fascial plane blocks; anesthesiology and reanimation physicians' approach in Türkiye: A national survey study.

Our aim was to assess the approach of Turkish Anesthesiology and Reanimation Specialists to the perioperative use of truncal/fascial plane blocks (FPB) in various surgeries. A survey was designed to evaluate the perioperative management of FPBs. Anesthesiology and Reanimation specialists and residents in various hospitals in Türkiye were surveyed on a voluntary basis. We contacted them between June 1 and September 10, 2022, using email and smartphone messenger applications. They were asked to complete a questionnaire form regarding the perioperative management of FPBs. A total of 242 anesthesiology specialists and residents responded to the survey. Most participants (42.3%) were anesthesiology specialists in 3rd level (academic, teaching, or university) hospitals. 90% of the participants use these blocks in their clinical practice. The primarily used FPBs were the erector spinae plane (ESP) (629 responses in all categories). The anesthesia and reanimation specialists in Türkiye are reasonably familiar with FPBs and use these blocks frequently in clinical practice. The primarily preferred blocks seem to be ESP and TAP blocks. Lack of equipment is a major reason for the non-performance of FPBs. There is still a lack/need for additional education and training for these blocks.