Psychomotor objectives are achieved with supervised clinical experience, simulations, artificial models, role-plays, standardized patients, and audio or visual review of skills. Affective objectives may be achieved with exposure ( e.g., readings, discussions, and experiences), facilitation of openness, introspection, reflection, and use of role models. Methods that are commonly used to achieve cognitive objectives include readings, lectures, audiovisual materials, programmed learning ( e.g., practice tests with feedback), discussion, and problem-based learning. Lipsett and Kern 77 describe three types of learner objectives and the methods used to achieve them. 74–76 It is unclear which of these strategies will be most effective in an anesthesia-specific hand-off curriculum, because educational strategies have differential effectiveness depending on the chosen goals and objectives. A variety of strategies for teaching hand-off skills have been published, including didactics alone, 64 didactics sessions and role-playing, 65–70 simulation, 71–73 and Web-based activities. Once objectives and content are established, content delivery approaches must be considered. 62 We condensed the published I-PASS goals from eight to five and provided examples of implementation in order to highlight their relevance to anesthesia practice ( table 4). ‖ The group and its curriculum are both entitled I-PASS, which is a mnemonic that stands for Illness severity, Patient summary, Action list, Situation awareness and contingency planning, and Synthesis by receiver. We adapted goals and objectives developed by a group that designed a comprehensive hand-off curriculum for pediatric residents. The lack of literature focused on developing and delivering hand-off curriculum specific to anesthesia makes it necessary to draw from other disciplines that have considered these curriculum development issues. 61 Establishing broad educational goals and specific measurable objectives for hand-off education is an important first step in developing a hand-off curriculum. Third, intraoperative handoffs may be prompted to occur at predetermined times of shift change unrelated to or in conflict with procedural milestones ( e.g., incision, closing), leading to shorter, hurried handoffs that lack vital patient information.Ĭurriculum design should incorporate content selection, content delivery, and evaluation of the curriculum and assessment of trainees ( fig. Second, handoffs in the OR may encounter barriers to effective communication ( table 3), 48, 55, 56 including poor lighting, chaotic environment, too much noise, and multitasking. In cases with both a supervising attending and a resident or nonphysician anesthetist, two handoffs may occur simultaneously. Care may be transferred between different personnel types, providers with varying levels of training, for various periods of time, and, in the case of attending physicians, handoffs may occur distant to the site of care. First, intraoperative handoffs involve several dimensions of transfer ( table 2). Intraoperative handoffs, a type of shift-to-shift or duty relief, merit special mention because they have important features distinguishing them from transitions of care. These recommendations were developed to assist in compliance with current ACGME requirements for residency programs, including those in anesthesiology. † The purpose of this article is to review the literature about handoffs in anesthesia and related fields to develop curriculum development and evaluation recommendations for anesthesiology resident education leadership. * The Accreditation Council for Graduate Medical Education (ACGME) also recognizes the importance of handoffs and requires that all ACGME-accredited programs ensure that their residents are competent in hand-off communications. 1–3 The Joint Commission, the body that accredits hospitals and other healthcare organizations in the United States, recognized that hand-off standardization could improve communication quality it designated hand-off standardization as a national patient safety goal in 2006. HANDOFFS’ contribution to healthcare quality is being increasingly recognized as evidence grows linking communication defects to patient safety lapses.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |