Ed Kosik, DO, FASA
Associate Professor, University of Oklahoma HSC 
John H. Saxon III, M.D. Professorship of Anesthesiology
Medical Director of Anesthesiology Simulation

The uncertain times of the COVID-19 pandemic brought out our best as we stayed focused on the safety of our learners and our educational mission. Even though our Simulation Center was officially closed, extensive education efforts took place.

Zoom lectures were offered on a multitude of anesthesia related topics. Simulation, both screen-based and high fidelity, was used extensively to educate our medical students. A simulation session that seemed straightforward before the pandemic took substantially more effort because we had to sanitize all the equipment and operate the simulators without the aid of technicians. Finding masks, gloves and sanitizing equipment was challenging. The debriefing skills that I obtained over the years helped to address and humanize medical students’ and residents’ concerns about COVID-19 and the effects on their education.
 
The fortitude of my colleagues both clinically and educationally was paramount.  We figured out how to make education work despite a potentially dangerous clinical situation.  An instructional video for donning and doffing personal protective equipment was literally made overnight; lectures were provided; mock oral board exams were successfully held; anesthesiology mock OSCEs were modified and successful; and ACLS classes were held in smaller groups. All of these efforts were made as we practiced social distancing and adhered to institutional safety guidelines.

I am more thankful than ever for my anesthesia colleagues and the people I am surrounded by. It is through their bravery and collaboration that we keep striving to move forward to make the best out of a challenging situation and never losing focus of the things that matter. 

Albertz, M1

Hoagland, M1

Masaracchia M1

LeRiger M2

Dachsangvorn, O3

Chatterjee, D1

 

Monica Bhutiani MD

Brian Gelfand MD

Meredith Kingeter MD

The transition from intern year to clinical anesthesiology represents an exciting but challenging time. Historically, our program utilized June of PGY1 year to prepare interns to work in the operating room. During this month, a hands-on and didactic educational format facilitated residents’ progression from paired oversight to semi-solo to eventually solo status by July 1st of CA-1 year.

Responding to local and national concerns of resident burnout, especially during the current pandemic, we restructured the program with emphasis on wellness and burnout prevention, while still ensuring intraoperative competence based upon established metrics. We incorporated strategies including paired intraoperative mentorship with predictable and assured OR relief, evening online lectures in interactive PBLD format, and resilience workshops.

During this transition period both intraoperative as well as social and emotional supports are imperative to decrease burnout and bolster mental wellbeing. Traditionally, interclass friendship and camaraderie vital for the forthcoming clinical years stems organically from frequent social interactions both within and outside the hospital. However, due to infectious concerns, many of those opportunities are not possible this year. With some creativity, we supplemented their curricula with online weekly social hours to facilitate debriefing, decompression, and growth as a class as well as a structured 1:1 peer mentorship program that paired rising CA-1 residents with senior mentors to provide psychosocial support, encourage self-reflection, and bolster professional connectedness.

Overall, these changes were implemented for the well-being of our residents, especially in the current climate shaped by COVID-19. Although the impetus for these changes was the pandemic, we believe resident wellness represents a needed priority even in times of normalcy, and we will continue to build upon these changes towards a programmatic paradigm shift of greater resident support and wellbeing. 

Lisa Caplan, MD

Kathleen Chen, MD, MS

David Young, MD, MEd, MBA

 

 

L. Jane Easdown, MD

A few years ago, the SEA Board of Director’s launched an outreach program to contact other anesthesiology societies to offer workshops and share resources and educational material. This outreach program is led by Dr. Deb Schwengel. One of the advantages of the outreach has been learning about the other societies and what they create and offer to members. The Society of Neurosurgical Anesthesia and Critical Care (SNACC) is one of the societies with a strong education focus. SEA members may benefit from familiarity with SNACC’s offerings, which can help both training programs individual trainees. 
  
SNACC membership comprises neuroscientists, neurointensivists and neuroanesthesiologists. The society was founded in 2007 and has traditionally had a one-day meeting ahead of the ASA, which made it very difficult to SEA members to attend. SNACC had its first freestanding meeting in September 2019, which allowed for additional days of programming. For the first time, a group of SEA members could attend the full meeting! SNACC leadership was keen to work with SEA to provide new experiences for their membership. Through this relationship we have learned that SNACC has many educational resources for use for the general public.

SEA/SNACC Workshop- SNACC invited SEA members to conduct a workshop for the September 2019 meeting, and from several topics offered they chose curriculum development. Deb Schwengel organized a workshop with Karen Souter, Shobana Rajan and me as presenters and. The workshop was fully subscribed including many of the SNACC officers. Several attendees were developing a new rotation, so this workshop was very timely. We presented the Kern system for curriculum development. This was highly successful, and we have been asked to provide other topics in the future.   
 
The SNACC website-  For those of us that teach in neuroanesthesia rotations there is a wide variety of educational material to be found on the SNACC website, and it is open to the public. Three sections are worth highlighting:

• Education Corner: You can find PBLDs, quizzes, interesting cases, blogs, discussion boards and best articles of the week etc. The SNACC Education Committee and the Committee on Trainee Engagement create and edit this material.   
• Neuroanesthesia Classroom: The Committee for Trainee Engagement has developed a 4-week rotation curriculum for neuro rotations. This curriculum is linked to SNACC resources such as review articles or PBLDs. This can be a terrific way to compare with a national standard and also as a guide for new programs. It will direct rotation directors to high quality educational material. Residents and fellows can use this curriculum and links for exam preparation.  
• Fellows and Residents: This is a section for trainees to find educational material. There is also information about neuroanesthesia fellowships. SNACC was instrumental in establishing an accreditation for neuroanesthesia fellowships. Under the leadership of Dr. Andrew Kofke, an international group, the International Council for Perioperative Neuroscience Training (ICPNT) was created to explore curriculum, evaluation selection and all other aspects of a training program. In 2019 the first neuroanesthesia training programs were accredited, and many more are in the process of accreditation. There is information on neuro fellowships on the site. Almost all academic anesthesia programs are recruiting for neuroanesthesia staff, and there is a huge need for highly qualified faculty.  

The SNACC newsletter- Anyone can subscribe. The latest newsletter describes the activities of the last meeting, ongoing projects, noteworthy research and updates on SNACC meetings. The newsletter has an education corner to keep you up to date with the output from active education committees at SNACC.   

In summary, through the SEA outreach program we have made a strong connection to SNACC. This group is highly focused on education and has open resources that all programs can use. I hope this shows how SNACC’s resources can benefit medical students, residents and fellows. Continued outreach to anesthesia societies will help us find common ground that will enrich us all. 

Barbara Orlando, MD

When I moved to the United States and decided to go back to work after an eight-year break to take care of my kids, I did not imagine how tough it would be to enter the workforce the second time around. As an attending I took interest in wellness after going through a pretty rough residency and reading more and more stories about burnout and suicide among our lines. Having a daughter interested in going into medicine was another reason to try to improve this growing problem. 

2020 SEA Fall Meeting Preview: "Advancing Your Educational Scholarship"

Susan M Martinelli, MD FASA SEA Fall Meeting Chair

Robert S Isaak, DO FASA    SEA Fall Meeting Co-Chair

Fei Chen, PhD, MEd    SEA Fall Meeting Co-Chair

 

Herodotos Ellinas, MD Associate Professor Medical College of Wisconsin Milwaukee, WI

Book Review: The Five Dysfunctions of a Team
Book Author: Patrick Lencioni
Publisher: Jossey-Bass, an Imprint of Wiley
Review Author: Herodotos Ellinas

High-performance teams are not the result of sheer luck. During a crisis such as the COVID-19 pandemic, leaders must assemble effective multidisciplinary teams or adapt existing ones. Leaders who assemble such teams should base membership on a careful evaluation of talents, which includes assessing members’ interactions and evaluating their critical thinking when they navigate rapidly changing terrains. Although Lencioni does not discuss an extreme crisis in The Five Dysfunctions of a Team, the reader can extrapolate from the author’s key concepts. Lencioni narrates a fable of an organization that hires a new CEO, Kathryn, to revive a struggling company. The author, in this easy-to-read book, cleverly walks the reader step by step through Kathryn’s challenges in putting together a “high-functioning” team.  

An old-school executive hired at a high-tech Silicon Valley company, Kathryn arrives at her first day of work and discovers that her staff of seven talented executives have total inability to work well together. Their constant disagreements and incapacity to take responsibility for their actions impart negativity to the workplace, further contributing to the existing chaos. As an experienced leader, Kathryn quickly realizes the dysfunction of these executives and subjects them to a pair of off-site retreats to identify the underlying issues that led to the company’s current situation. In the process, some of her decisions make her unpopular, but her persistence prevails in creating a high-performance team. 

Thirty years ago HIV/AIDS still held thrall of the world.¹ I wrote the following as I switched careers from law to medicine:

It was the call I received regarding the HIV positive man whose will I had executed one week earlier which made me reflect on the difference between the power of words and the fight for life.  The news of his death recalled the irritation I had felt at trying to get him to meet with me to devise ways to settle an estate of which the greatest asset was the eleven-year-old son he would leave behind alone.  The moment that I heard of his death, all of the work, all of the time, all of the trouble was absolutely meaningless...trite.

Emuejevoke Chuba, MD PGY-2 Anesthesiology Resident Temple University Hospital, Philadelphia

Major Stephanie Parks, DNP, CRNA Task Force 13 Strike Team Alpha OIC Temple University Hospital

This was another successful year for the SEA/HVO Fellowships. We received 22 applications and awarded 8 Fellowships. See the HVO announcement below. The new Fellows will be traveling to Vietnam, Rwanda or Ghana for their month of teaching anesthesia residents, anesthesia nurses or anesthesia clinical officers. Congratulations to them all.

Health Volunteers Overseas (HVO), in collaboration with the Society for Education in Anesthesia (SEA), is pleased to share that eight anesthesia residents will receive a 2019 SEA-HVO Traveling Fellowship.

We look forward seeing you at the SEA 33rd Spring Meeting, which will be held next week at the Hyatt Regency Louisville. To tie into the ACGME’s initiative on wellness, the theme is “Training Professional, Humanistic Anesthesiologists.” This theme is especially relevant to our fast-paced, technologically advanced world which, according to some academic gurus and observers, is experiencing a crisis of humanism and professionalism in the practice of medicine.

The meeting will open with a plenary address by Dr. Thomas J. Nasca, MD, MACP, CEO of the ACGME, professor of medicine at Thomas Jefferson University and senior scholar in the Department of Medical Education at the University of Illinois at Chicago School of Medicine. Several nationally known speakers will address issues relevant to humanism as panel discussion. Friday will conclude with dynamic and interactive workshops that relate to professionalism and humanism. Dr. David Chestnut, MD, Professor and Chief of Obstetric Anesthesiology, Vanderbilt University Medical Center and senior editor of Chestnut’s Obstetric Anesthesia: Principles and Practice will be the plenary speaker for Saturday. The issues relevant to professionalism will be addressed in two TED-style panels discussion followed by additional workshops.

Karen J. Souter, MB, BS, FRCA, MACM

A new initiative

Do you remember your first SEA meeting? For many of us, it was several years ago. There was something special that drew us to be long term SEA members. Perhaps it was a spark ignited through the meeting theme or content. Maybe we met a kindred spirit in education at the dine around. We are interested in how our members became invested in SEA.

Integration of Technology into Anesthesia Practice & Education

 

The Road to Character

Book Author: David Brooks
Publisher: Random House 

Opinion

Communication in Perioperative Education

Jonathan Hastie, MD

In a recent meeting with the family of a critically ill patient, we deliberated about pursuing an aggressive operation to control the source of sepsis. Because the surgeon was not able to attend the meeting, a resident came in his place; at one point I asked the resident to describe the procedure in question.

To my surprise, the surgical resident described not only the technicalities of the procedure, but also outlined several additional considerations: the likely outcome, the relevant concerns, the alternative options, and how all of the above fit into the patient’s current condition. The resident spoke clearly, included relevant facts, and used language that was readily understandable to the anxious family members. Equally important, the resident’s manner was engaging and compassionate.

I later learned that this particular resident had recently participated in a communication skills training program.¹ In this program, small groups used role play to practice and to generate real-time feedback. Residents assessed their own preparedness before and after the session, and they reported high satisfaction and frequent subsequent opportunities for application. In this case, I witnessed these skills used in an actual encounter, in which the resident’s communication guided decision-making and supported the family.

Education Workshop in Karachi Pakistan

Zulfiqar Ahmed, MD, FAAP
Siromed/Anesthesia Associates of Ann Arbor
Director of Education and Pediatric Anesthesia
Wayne State University Anesthesia Residency Program
St Joseph Mercy Oakland Hospital
Pontiac, MI

Karen J. Souter, MB, BS, FRCA, MACM