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Report on the Society for Education in Anesthesia Spring Meeting 2009: “Educating About Safety: Educating Safely” Cosponsored by the Anesthesia Patient Safety Foundation, University of Washington Medical Center and Virginia Mason Medical Center, Seattle, WA, June 4–7, 2009

2010; Lippincott Williams & Wilkins; Volume: 110; Issue: 2 Linguagem: Inglês

10.1213/ane.0b013e3181c293e2

1526-7598

Jane Easdown, Leila Mei Pang, Karen J. Souter,

Innovations in Medical Education

Report on the Society for Education in Anesthesia Spring Meeting 2009: “Educating About Safety: Educating Safely” Cosponsored by the Anesthesia Patient Safety Foundation, University of Washington Medical Center and Virginia Mason Medical Center, Seattle, WA, June 4–7, 2009 The Society for Education in Anesthesia (SEA) was founded in 1985 to support professional educators in anesthesiology. The year 2010 marks the 25th anniversary of the society with a growing membership of 650 physicians, residents, and medical students. SEA offers 2 annual meetings and 2 workshops on teaching each year. The theme of the 2009 Annual Spring Meeting held on June 4–7, 2009, in Seattle, WA, was “Educating About Safety: Educating Safely,” and was attended by more than 200 participants. There were 16 invited speakers and 54 SEA members participating in plenary sessions and 21 workshops. A special program presented by the Anesthesia Patient Safety Foundation (APSF) covered topics in education and safety, introduction of new equipment, and working with industry. Dr. Gary Loyd, president of SEA (University of Louisville), and Dr. Karen Souter, Meeting Chair (University of Washington), opened the meeting. Dr. Debra Schwinn, Professor and Chair of Anesthesiology and Pain Medicine (University of Washington), gave the opening keynote address entitled “The Safety of Academic Medicine.” She suggested that without strategic vision, academic medicine will not be preserved in a difficult economy.1 To develop the next generation of academic and nonacademic anesthesiologists, high standards need to be set by not training just “safe” physicians, but training physicians who show mastery through deliberate practice, rigorous fellowship training, and research. With the advent of the health care team, there will be more pressure to be leaders, not just practitioners. This is a marathon effort, not a sprint, and will require research mentors, multidisciplinary teams, and the need to overcome discouragement through clear visions and “outrageous ambition.” The second speaker, Dr. Paul Preston (Kaiser Permanente), spoke about the safety initiative in a health maintenance organization. He described practical ways to address error reduction. Critical elements include structured communications in the perioperative area and medication safety alerts. Strong leadership and incentives based on quality of care with descriptors that are transparent and known to all physicians are 2 key factors for success. Dr. Preston stressed the use of “in situ” simulation to train teams and to test new procedures and technology. Building a “culture of safety” is inherent in Kaiser's plan for the future. The plenary sessions and workshops presented by the APSF formed a major highlight of the meeting. The first plenary session was chaired by Dr. Matthew Weinger (Vanderbilt University) entitled “Developing a Safety Curriculum for Residents and Medical Students.” An international perspective was offered by Dr. Tim Shaw (University of Sydney), who discussed the development of safety curricula drawing on many different examples from Australia and the international forum. He emphasized how developing a curriculum in safety can be both exciting and engaging and related the importance of using a “stealth” approach (i.e., introducing the curriculum gradually using many clinical examples to offset a misconception that safety is boring!). He introduced the concept of spaced education, a process whereby educators e-mail short, case-based questions to participants in a repeating pattern over the period of the program. Relevant links to more information are provided after the question has been correctly answered twice. Dr. Edward Dunn (National Center for Patient Safety, Department of Veterans Affairs) expanded on the development of safety education including a safety fellowship offered by Northwestern University and collaboration with the Institute of Medicine on the Patient Safety Education Project. Finally, Dr. Weinger presented curricula being developed in simulation at Vanderbilt University in the Departments of Anesthesiology, Surgery, and Emergency Medicine. He emphasized that the use of simulation must include a robust evaluation process. Physicians and nurses should be trained together, and measured outcomes should include a change in behavior and/or improvement in patient care. The second APSF plenary session was chaired by Dr. Michael Olympio (Wake Forest University), who noted in his introduction that because of the current changes in continuing medical education policy, expert representatives from industry will be less likely to participate in educational meetings. This observation was further developed by Dr. Nikolaus Gravenstein (University of Florida), who discussed the complex relationship that must exist between industry and educators, so that the safe use and development of technology can advance without conflict of interest. Dr. James Eisenkraft (Mount Sinai School of Medicine in New York City) spoke about how to best teach residents about anesthesiology technology. Dr. James Szocik (University of Michigan) presented the difficulties of learning and teaching new technology: “Leaders need to know more than the knobology (i.e., the function of each button on a monitoring device) of the new technology. They must understand the underlying principles of technology, its capabilities, and know how to apply it in different situations to maximize the benefit.” A series of workshops on how to teach safe practices in various “high tech” areas of anesthesia and the operating room followed. Albert de Richemond, MS PE (Emergency Care Research Institute), and Dr. Mike Boyer (Northwestern University) presented a comprehensive program on how to teach fire safety in the operating room. Drs. Szocik, Sarah Bodin (Wake Forest University), and Pamela Nagle (Wake Forest University) ran a successful workshop on teaching about infusion pump operation. Because the key differences between pumps are in the software, different pumps were evaluated in an attempt to identify the heuristic applicability to our practice and the teaching points involved with each characteristic. An in-depth consideration of teaching anesthesia machine safety was presented by Drs. Olympio, Eisenkraft, and Roger Johnson, CBET (Children's Hospital of Wisconsin), and William Paulsen, PhD (South University, Georgia). The secondary theme of the meeting “Educating Safely” was addressed by a number of workshops that explored serious issues such as “How to Teach Safely and Effectively in the Operating Room,” “How to Deal with Traumatic Perioperative Events,” and “Managing Depression in Anesthesiologists, Particularly Trainees.” A lively panel discussion led by Kristin Miles, JD, Assistant Attorney General of Washington State, and Joseph York, PhD, Past Associate Dean for Graduate Medical Education (University of Washington), reviewed the legal implications for residency programs when disclosing information. Drs. David Wilks and Richard Driver (West Virginia University) continued this general theme in their workshop “My Program Could Be Placed on Probation: Strategies to Survive and Prosper.” Other workshops offered during the conference included “The Safest Generation” (Dr. John Wasnick, Columbia University). The future of our specialty currently resides in the Millennial Generation (born 1982–2002). Attributes of this generation include team orientation, desire for predictability, and ease with technology, traits that are favorable for the millennial anesthesiologist of the future. The concern, however, is that anesthesiology is not predictable and requires independence and quick thinking. The SEA Committee on Simulation presented 4 workshops underscoring the importance of simulation as an educational tool for teaching residents in a safe environment away from the operating rooms. The final plenary session chaired by Dr. Stephen Rupp (Virginia Mason Medical Center) highlighted the success of adopting the “Toyota Model—Lean Methodology” into a busy private medical center, and he discussed how a vibrant residency training program can still flourish in a culture geared for safety, efficiency, and cost saving. The SEA Research Committee selected 25 abstracts on education research and curriculum development for moderated poster sessions and 2 oral presentations. The SEA Committee on International Outreach/Developing World supports the work of Health Volunteers Overseas by contributing scholarships to residents and fellows to encourage them to teach in the developing world. Drs. Jo Davies (University of Washington) and Lena Dohlman (Harvard Medical School) presented a session on the importance of practicing and teaching about safety while on educational missions, with special consideration to the importance of keeping oneself safe and healthy. The SEA Faculty Development Committee offered a novel program of peer assessment and mentoring for members who requested expert feedback on their presentation and teaching skills. This program accomplishes 1 of the SEA missions of assisting educators with their own academic development. A workshop for advanced educators held on the Thursday before the meeting was another activity to aid academic development. To foster the development of future anesthesiology educators, SEA hosted the Chief Residents Leadership Workshop. Forty senior residents attended the meeting and a parallel session on Saturday devoted to leadership strategies, administration, and networking. In summary, the joint participation of APSF with SEA achieved the program goals of teaching anesthesiology educators about safety and safety-related technology, enabling them to teach these topics more effectively. The maintenance of a safe environment while educating anesthesiology residents and medical students was addressed. The theme for the next SEA meeting, “Teaching in the Face of Adversity,” will be held on October 16, 2009 (before the American Society of Anesthesiologists annual meeting) in New Orleans (see www.SEAhq.org for more information). Jane L. Easdown, MD, FRCPC Department of Anesthesiology Vanderbilt University Medical Center Nashville, Tennessee Leila Mei Pang, MD Department of Anesthesiology Columbia University College of Physicians and Surgeons New York Presbyterian Hospital, New York, New York Karen J. Souter, MB, BS FRCA Department of Anesthesiology and Pain Medicine University of Washington Medical Center, Seattle Washington [email protected].