Didactics, Simulations and Practice Exams
Overview of Didactic Program
Our residents are postdoctoral students, so they should be experts at learning. We believe that our residents bear a large responsibility for their own learning. However, it is the faculty's job to guide them in this process. Therefore, we have a program of formal lectures, visiting professors, PBLDs and small group discussion sessions, journal clubs, workshops, practice oral boards sessions, and a very lively Clinical Case Conference (M and M). We also have an active simulation-based learning program. The curriculum (rotation-specific goals and objectives and recommended educational resources) is all online and can be accessed by residents at any time.
In recent years, our didactic program has been restructured to allow for dedicated educational time. Each Wednesday, one clinical anesthesia class is relieved from clinical duties to participate in core didactic activities for an entire day. These Wednesdays alternate between the three classes, so each class has a dedicated Academic Day once every 3 weeks.
In addition, the ORs start late on Tuesday mornings to permit time for education and meetings for physicians, nurses, and other allied health personnel. For Anesthesia residents, these sessions alternate between Grand Rounds, Morbidity and Mortality (M&M) conference, Visiting Professor Presentations, and resident meetings, each taking place from 7am to 8am. Certain subspecialty didactics (such as OB anesthesia or pediatric anesthesia) take place prior to these sessions from 6:30 to 7 a.m. on Tuesdays as well.
Didactics are Specific by Training Level
Didactics during CA1 year are devoted to topics in basic clinical anesthesia (anatomy, physiology, physics, pharmacology, anesthesia basics). In January and February, the Tuesday morning teaching sessions are devoted to Basic Exam and In-Training Exam prep.
Didactics for CA2 and CA3 residents are focused on subspecialties within anesthesia. Topics also include research design/statistics and practice management.
The University of Iowa has also partnered with the Departments of Anesthesiology at the Universities of Minnesota, Nebraska and Wisconsin to share didactics related to practice management. Approximately four times per year, the residents have access to real-time presentations (including Q&A sessions) by local, regional, and national experts.
Workshops, Practice Exams, and Resources
The department regularly sponsors workshops and symposia such as:
Basic TEE Review Course
Obstetric Anesthesia Symposium
Operations Research for OR Management
Regional Anesthesia Study Center of Iowa (RASCI)
Statistical Methods for Anesthesia
Twice a year, residents participate in practice oral exam sessions. The department has six faculty members who are ABA oral board examiners, and they help the faculty and residents prepare to pass the ABA applied examinations (oral boards) and OSCE (Observed Structured Clinical Exam).
Finally, residents have access to many online educational programs that are paid for by the department, including virtually any Anesthesia textbook you can imagine, the ASA Anesthesia Toolbox, TrueLearn SmartBanks, PassMachine Board Prep, PTE Masters Echocardiography, Hall’s Comprehensive Review Questions, and an almost unlimited amount of internal/external lectures and Journal Club articles. Last year, we also created the “Virtual Anesthesia Lounge”, which is a Microsoft Teams page dedicated to collecting educational resources (lectures, study guides, content outlines, etc.) and organizing them in a way that is ideal for the learning anesthesia resident.
Simulations as Practice and Preparation
Within the Department of Anesthesia at UIHC, we have an extensive simulation program—with two staff members dedicated solely to organizing and moderating simulation sessions for Anesthesia residents. During the OR orientation in the latter half of intern year, there are multiple simulation sessions aimed at preparing the interns for basic OR anesthesia processes, such as induction and extubation. During the Clinical Anesthesia (CA) years, simulator sessions are scheduled for individual residents throughout the day on rotations that allow for more flexibility (such as Acute Pain, Regional Anesthesia, Academic, or Echo rotations).
Simulation training at the University of Iowa is active and varied. We offer:
Lab-based simulations (uncommon OR problems or common problems with potentially devastating outcomes)
Actor-based activities (incorporating professionalism, communication, and delivering bad news)
Team-based, Crisis Resource Management (in-situ scenarios in the Emergency Department, OB, PACU, SNICU/CVICU and other locations throughout the hospital)
We have established a set of simulation scenarios that all residents must complete before they graduate from this residency training program. In addition, we also have a set of scenarios that are tailored towards the novice/orienting trainee.
Simulations are scheduled Monday through Friday. Multiple simulation activities occur each day. Residents who are not on OR rotations are scheduled to participate in simulations frequently during the non-OR rotations.
The ACGME requires participation in at least one simulation per year. Residents at Iowa can expect to participate in approximately 40 simulations throughout the residency (either as teacher, "primary care provider," or as the expert who “shows up to help" when the primary care provider needs assistance.
Education as a Focus
Our residents work hard; they cannot gain real expertise without it. But we never forget that there is more to learning than simply doing a lot of cases. They need to be the right cases, and they need to be supplemented by didactics.
To ensure this, we carefully track and manage resident case mix and case load–not just duty hours. We have protected time for lectures and problem-based learning discussions (every third Wednesday). Simulator time is scheduled, not just handled on an ad hoc basis. Residents also have non-clinical, dedicated Academic rotations (approximately four weeks distributed throughout the three-year residency).