Successful Transition to Anesthesia Residency Training

Background: The ACGME has recommended that anesthesia residency programs integrate the internship year with the three-year anesthesia training. Because Stanford Anesthesia does not offer an integrated program, a 10-month blended-learning online education and virtual mentorship program using Learning Management System (LMS) and Lecture Capture (LC) technology was designed to facilitate the transition from internship to residency. Objective: The goal of this educational informatics study was to assess the efficacy of this program to improve self-reported preparedness scores via a prospective, observational study. Methods: The START intervention is an online program divided into 10 monthly modules with three components: a video podcast featuring clinical vignettes and mini-lectures; 20-minute lectures accompanied by quizzes; and an interactive/collaborative activity. The curriculum was designed based on a needs assessment conducted through focus groups and a survey of incoming CA-1 residents. The curriculum was created to address basic knowledge and skills (e.g., basic preoperative evaluation, management of low blood pressure in the OR) necessary to begin anesthesia residency. It incorporated each of the six ACGME core competencies. Each intern was paired with a CA-1 mentor. The interns' ratings of the curriculum were assessed through monthly web surveys. Gains in anesthesia-related knowledge were measured with pre- and post-quizzes for each online lesson. After IRB approval, a survey to measure the interns' self-assessed preparedness to begin residency was administered before internship, after internship, and after one month of residency. Preparedness scores of the START participants were compared to the scores of a previous class that did not receive the START intervention to assess the efficacy of the START program to enhance interns’ self-perceived feelings of preparedness. Results: Before beginning the START program, two thirds of interns felt unprepared to perform 14 common CA-1 tasks, including setting up the OR, developing an anesthetic plan and waking the patient up. Assessment of the START program to increase these self-reported measures of preparedness will be conducted June 1-3, 2010 and presented at the Congress. (Unless otherwise noted, results below are reported on a 0 (not at all) to 10 (extremely) scale with average±stdev). Interns rated the podcasts very highly on a liking scale (9.1±0.12). These podcasts were also rated very highly on their usefulness for residency preparation (9.0±0.38). Content-based online lectures were also highly rated in liking (9.0±0.05) and usefulness (9.0±0.24) scores. Anesthesia-related knowledge increased on average by 25±14% (p<0.05) after each monthly lesson, as assessed by pre- and post-quizzes. 100% participation in all months was observed. Importantly, the interns did not feel the curriculum was too burdensome during their CB-1 year, and reported high satisfaction with the lesson length (8.6±0.48) and number (8.6±0.82). Conclusion: To our knowledge, the START program represents the first blended-learning and virtual mentorship program using integrated LMS/LC technology and virtual mentorship that is designed to enhance residency preparation for CB-1 residents in any medical specialty. The START program uses informatics tools to deliver an enjoyable, useful and manageable preparation for anesthesia residency. Such a program may be particularly useful for departments without an integrated internship year. []