Welcome to the Society for Education in Anesthesia (SEA) website! 2020. Certainly an interesting time to take on the role of president of the Society for Education in Anesthesia

Stephanie B. Jones, MD SEA President

2020. Certainly an interesting time to take on the role of president of the Society for Education in Anesthesia (SEA). The COVID-19 pandemic forced us to cancel Spring Meeting 2020 and prompted an adept pivot to a virtual format for Fall Meeting 2020. These adaptations reminded us of what we already knew: that SEA must continuously reinvent itself to best serve anesthesia teachers and learners.

Reinvention emerged as a focus of our 2018 strategic planning session, led by Dr. Karen Souter, immediate past president. The plan developed that evening in San Francisco centered on improving our meetings with inspirational speakers and innovative presentation formats, collaborating with other groups, and supporting our committee structure and emerging leaders. To enact this ambitious plan, we would use the considerable expertise and talent that exists within our ranks to provide value for members. Much was accomplished over the following two years, and when the pandemic forced rethinking of our traditional in-person educational meetings and committee work structure, it simply accelerated the process. 

The December 2020 strategic planning session, held virtually, manifested this acceleration. This meeting was notable for engaged discussion and energetic deliberation. The meeting started with a quick roundtable SWOT analysis (strengths, weaknesses, opportunities, threats). Interestingly, the close-knit nature of the SEA community was identified as both a strength and weakness. Those outside or new to the organization might perceive the welcoming familiarity at annual meetings to be insular. The necessary shift to a sustained virtual platform has created opportunity for improving inclusivity. The virtual Fall Meeting 2020 and preceding online workshops were a strong initial success, creating a platform of experience on which to build further. We recognize that we cannot entirely return to our previous baseline. 

The stage was thus set for the three breakout groups. The main topic of discussion for each group was derived from a request emailed to directors and committee chairs the week prior, asking them to propose one goal relevant to their committee's mission and another relevant to SEA's overall mission. Dr. Souter led the meetings group; Dr. Bryan Mahoney website and technology; and Dr. John Mitchell faculty development.  Each group drafted an action plan while keeping SEA’s values—Collaboration, Innovation, Scholarship and an Inclusive Community—in mind.

The meetings discussion emphasized harnessing the online momentum by expanding our social media presence, exploring the logistic possibilities for hybrid meetings, and developing online offerings independent of our traditional semi-annual meeting calendar. The website/technology goals formed along similar lines – how to create and present website content that is available and useful to members and non-members. Finally, the faculty development discussion focused on how to train mentors and how to mentor in research, education, and professional societies. 

One clear message emerged with an implication about openness and access: In order to most effectively and efficiently affect anesthesia education, our knowledge needs to be freely available. We can no longer rely on our traditional meetings and workshops as our primary source of income or cloister our content behind password protected firewalls. Our commerce, our coin of the anesthesia realm, is to develop our educators.  To do so, we must create open content, foster innovation, and mentor the next generation of anesthesia education leaders. This is SEA’s role and what will set us apart from other anesthesiology organizations, allowing us to thrive in the new, post-pandemic, education world. 

This year, the Society for Education in Anesthesia is commemorating its 35^th anniversary. It was unfortunate we could not all be together in Washington, D.C. to celebrate. Nevertheless, we were so happy to see everyone who attended SEA’s Fall Meeting 2020 in its first ever virtual format. The meeting’s theme was “Educational Scholarship,” as we described how anesthesiology educators can create publications or other scholarly output from their curricular and educational efforts. We had an informative program full of amazing speakers this year, and we would like to share a summary of highlights from the meeting. 

The first section of the meeting focused on “Why and Where to Publish Your Educational Work.” Dr. Grace Huang kicked-off the meeting by delivering the McLeskey Lecture, in which she encouraged us to make a habit of incorporating writing into our professional lives. She emphasized that scholarship is within everybody’s reach and that there are opportunities to publish in education beyond original research projects. Next, we had a panel session on non-traditional publishing venues, during which Dr. Jed Wolpaw described how podcast development can be incorporated into your curriculum vitae and assist with promotion. He also encouraged others, especially those in subspecialty practice, to develop their own podcasts. Dr. Fei Chen presented us with innovative methods for the peer review process and how such innovations address some of the challenges in traditional review and metascience. She left us with the hope that we will see the application of these innovations in anesthesiology journals in the near future. The final speaker on the panel, Dr. Steven Shafer, provided an editor’s overview of the ASA Monitor and introduced GitHub for non-traditional publication strategies. Dr. Shafer encouraged interested people to contact the editors of ASA Monitor with innovative ideas and expressed interest in a potential medical education column. 

The speakers of the second section, Dr. Amy Miller Juve, Dr. Lara Zisblatt, and Dr. Amy DiLorenzo, described the numerous roles non-physician educational specialists can play in an anesthesiology department. Dr. David Zvara wrapped up the section, and first day of the meeting, with a chair’s perspective on how you can convince your chair to hire a non-physician educator.  

We started the second day of the meeting discussing how to publish your educational work. Dr. Lara Varpio gave us several great pieces of advice on creating an educational research paper, including how to frame your paper in the context of existing literature and how to make good use of your cover letter. Next, we received some fantastic insights and perspectives from two journal editors, Dr. Ed Nemergut (A&A) and Dr. Jeff Berger (JEPM), regarding practical tips and common pitfalls in educational writing. They each discussed several attributes of high-quality educational manuscripts and emphasized how effective design and writing can facilitate publication. 

To wrap up the meeting, we heard a very special presentation from Dr. Melissa Davidson and Dr. Stephen Kimatian, the SEA Duke Award Recipients for 2020. They both have been instrumental in the success of the SEA Workshop on Teaching and are extremely deserving of this prestigious award. 
 
Overall, the first virtual meeting of the SEA was a success. The feedback from attendees regarding the content, speakers, and format of the meeting was highly positive. More than 100 SEA members participated in each day of the meeting, many of whom found the virtual format very accessible. Additionally, the mixture of pre-recorded videos, live presentations, and live Q&A made for a well-rounded variety of formats. Although we would have preferred to be together at an in-person meeting we were still able to have a well-attended meeting, where SEA members received valuable education and professional development.

Hi,

This is our first Book Reviews podcast for the SEA Good Bedtime reads. My name is Viji Kurup and I am an 

Viji Kurup MD Professor Vice Chair for Medical Education Yale University

anesthesiologist at Yale University. The book I am reviewing for this edition of our newsletter is Tribal Leadership by Dave Logan, John King and Halee Fishcher-Wright.

When COVID hit our hospital, things changed drastically. We were working in unfamiliar territories. There was a lot of uncertainty and things were evolving quickly. The morale of my colleagues as well as my residents was dropping, and during one of my late night calls, I got talking with my call team and one of my residents mentioned a book named Tribal Leadership and how it described groups and cultures. This conversation sparked my interest and I read the book over the next few weeks. I also recommend the TED Talk by Dave Logan to get a sneak peak at his philosophy.

The author Dave Logan specializes in strategy and cultural performance and is a faculty member at USC’s Marshall school of business. He describes tribes within organizations that have distinctive identifiers. The book is meant to help leaders identify tribes of people within their organization and gives tools to upgrade their tribes’ culture stage by stage. The authors comment that this book is a result of research over 10 years across 24,000 people. 

The premise of the book is that it is possible to create high performing organizations if we pay attention to the culture of the people. In most organizations, cultures can be divided into 5 stages:

Stage 1 where the motto is ‘Life sucks’, where members feel that everything is futile and worthless. People are hostile and think that they need to band together to get ahead in a violent and unfair world. We may not see a lot of this except in individuals and even then, hopefully very rarely.

Stage 2 motto is ‘My life sucks’ where members feel that although things around them are good, they may not be having a share of it. We can see examples of these when we listen to people complain in our workrooms of how bad their lives are. People are passively antagonistic. They have seen it all before and watched it fail. They are sarcastic and resigned. 

Stage 3 motto is ‘I am great’ and by implication ‘You are not’ and is most commonly seen in academics where people individually achieve heights that the rest of the group may not reach. Here people are driven by their own ego to publish, get more titles and power within the organization. Here, winning is personal and they seem to be constantly disappointed that others don’t have their ambition or skill.

Stage 4 motto is ‘We are great’ where leaders inspire their groups to achieve unique outcomes and results. In this stage people naturally use ‘We’ when describing results rather than ‘I’. Team accomplishments are celebrated.  Everyone seems happy, inspired and genuine. Here the team comes together despite differences to work towards a common goal. 

Stage 5 is called ‘Life is great’ where the members work together towards aspirational goals and collaborate and communicate seamlessly. The group talks about infinite potential and how the group is going to make history because doing so will make a global impact. The group is constantly pushing the limits and is not in competition with anyone. 

The authors stress the importance of tribal culture and triadic relationships as opposed to dyadic ones, which seem to be important to form effective and stable relationships. The authors illustrate these stages and their relation to each other with very effective use of stories and examples from real life. For anyone who is looking to create effective teams and is currently in leadership or aspiring to be a leader, this book is a very good and easy read. 

After reading the book I could look around me and classify behaviors of people and see which stage they are currently in and what might be driving them, and what might inspire them to go to the next level. This book can add to your understanding of teams and provide some ideas on how to motivate your team and how collectively we can all achieve great things. I hope you enjoy this book.

I cannot remember where my first Society for Education in Anesthesia meeting was held or how I got there. It must have been in 1998 or 1999. I do vividly remember coming down to breakfast at about 7:30 that first 

Michael Sandison, MD Professor Emeritus  Albany Medical College

 morning and walking into animated committee meetings already in progress. I noticed one particularly large group brainstorming about upcoming meetings. I sat at an adjacent empty table and listened to the conversation. They were talking about themes for future meetings, possible speakers, interesting workshops and potential venues. I was struck by their enthusiasm, creativity and belief in the organization’s relevance and future. I had found “my people”.

Those people turned out to include Kathy King and Cathy Kuhn from Duke. At that time the Residency Review Committee had mandated that the departmental chair serve also as Program Director. Many chairs designated a faculty member as “Director of Education” or some such title. I had just been appointed to this “Quasi-PD” position by my outgoing chair at Albany Medical College. My predecessor, Kevin Roberts, had been appointed Acting Chair of the department. As he handed me a SEA newsletter, he offered me two words of advice for the new role: “Join SEA.”

I was woefully unprepared for this new position. Although I was regarded as a decent teacher by the residents and faculty, my approach to teaching was based simply on emulating my best teachers at the University of the Witwatersrand in Johannesburg. That first SEA meeting opened my eyes to the discipline of pedagogy and the possibility of a career in anesthesiology education. I returned home after that meeting recharged with a sense of direction, possibility and purpose.

Several meetings followed. I started making notes entitled: “Ideas from SEA”. The oldest list that I found was from the Spring Meeting of 2000, and it included a talk by Phil Lui entitled “Characteristics of Extraordinary Anesthesiologists: Implications for Anesthesia Education”. I later adapted that talk for inclusion in our introductory didactic program. Other entries in my notes include, “Look up the full Bloom’s Taxonomy”, (testimony to my lack of preparation as an educator) and “Writing is Thinking”.

That meeting led to my attending the SEA Workshop on Teaching, where I encountered people like Gary Loyd, Melissa Davidson, and Mike Olympio. This workshop laid the foundation for my ongoing education and professional development.

Over the next twenty years, SEA spring and fall meetings followed in places like Cleveland; Montreal; Harrisburg; Washington, DC; Nashville, and Santa Fe; with some of the best meetings being held in smaller cities, which I would never have thought to visit. “Dine Arounds” hosted by local SEA members gave me an insider’s perspective and a better appreciation of this vast and varied country. Friendships and collaborations followed. These relationships blossomed into mentorships and provided opportunities both to support and to be supported by others in the Society.

SEA has been central to the development of my professional career as an anesthesiology educator. I am grateful that I took Kevin’s advice to attend that first meeting.

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. 

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. 

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.

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.

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.