A retrospective review of required projects in systems-based practice in a single anesthesiology residency: a 10-year experience - 04/08/15
: Professor, Trent D. Emerick, MD b : Fellow, Rita M. Patel, MD c, d : Professor & Vice-Chair of Education, Associate Dean for Graduate Medical Education, Designated Institutional OfficialAbstract |
Study Objective |
The Accreditation Council for Graduate Medical Education has emphasized in its core competencies and more recently, in its Milestones Project, that residents understand the importance of systems-based practice (SBP). The objectives of the study are to evaluate the quality of residents' SBP projects and to determine the degrees that were subsequently implemented.
Design |
A retrospective educational observational study.
Setting |
A university-based anesthesiology training institution.
Subjects |
One hundred forty-nine anesthesiology residents in their final (postgraduate year 4) year of training who completed SBP projects for the last 10 years (2004-2013).
Interventions |
A structured SBP course was provided for postgraduate year 4 anesthesiology residents with deadlines set such as project identification, data collection, and proposal draft. Each resident's written SBP proposal received inputs by 2 members of the department executive steering committee. The SBP projects concluded with oral presentations by each resident to the department executive steering committee, who provided overall scores.
Measurements |
All SBP projects were categorized into 7 categories: safety initiatives, economic analysis, process analysis, policy change recommendations, education initiatives, teamwork/communication, and operating room efficiency. Evaluation scores using a Likert scale (1-9, where 9 is the best) were analyzed. The rate of implementation of project ideas within the department based on the presentations to the executive committee was examined.
Main Results |
Of 149 projects, policy change recommendations was the most frequently chosen category (46 projects; 30.9%), followed by process analysis (36 projects; 24.2%). The overall evaluation score was 7.6 ± 0.6 (mean ± SD). A total of 53 projects (35.6%) were implemented in the department. There was no statistical difference between SBPs with implementation vs SBPs without implementation in terms of evaluation scores, year of the presentation, or categories.
Conclusions |
This SBP project has given residents the opportunity to participate in a hospital system change aiming to improve efficiency and safety.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Systems-based practice (SBP) is 1 of 6 core competencies by the Accreditation Council for Graduate Medical Education. |
• | This study provides a long-term (10 years) result of SBP project. |
• | Policy change recommendation was the most frequently chosen category. |
• | 35.6% of SBP projects were implemented in the department. |
Keywords : Medical education, Medical education systems-based practice, Outcomes, Professionalism
Plan
| ☆ | Funding support: The authors report no external funding source for this study. |
| ☆☆ | Competing interests: The authors declare that they do not have any conflicts of interest. R.M.P. was a past member of the Accreditation Council for Graduate Medical Education (ACGME) review committee for anesthesiology and a current member of the ACGME institutional committee. The opinions expressed in the manuscript are not the ones of ACGME. |
| ★ | Authors' contributions: R.M.P. developed the program and maintained the data. T.E.M. and T.S. collected and analyzed the data. T.S. and T.E.M. wrote the draft. All authors reviewed the final draft and agreed the content. |
| ★★ | Previous presentations: The study has been presented, in part, as a podium presentation at the 2015 Spring Annual Meeting of the Society for Education in Anesthesia and the Association of Surgical Educators (Seattle, WA; April 24-26, 2015) and as a poster form at The 2015 Annual Meeting of the International Anesthesia Research Society (Honolulu, Hawaii; March 21-24, 2015). |
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