Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Review
Curriculum reform for residency training: competence, change, and opportunities for leadership.
Certain pressures stemming from within the medical community and from society in general, such as the need for increased accountability in resident training and restricted resident duty hours, have prompted a re-examination of methods for training physicians. Leaders in medical education in North America and around the world champion competency-based medical education (CBME) as a solution. The Department of Anesthesiology at the University of Ottawa launched Canada's first CBME program for anesthesiology residents on July 1, 2015. In this paper, we discuss the opportunities and challenges associated with CBME and delineate the elements of the new CBME program at the University of Ottawa. ⋯ Canadian anesthesia residency programs will soon transition to CBME in order to promote better transparency, accountability, fairness, fiscal responsibility, and patient safety. Competency-based medical education offers significant potential advantages for healthcare stakeholders.
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Randomized Controlled Trial
Bronchial blocker versus left double-lumen endotracheal tube in video-assisted thoracoscopic surgery: a randomized-controlled trial examining time and quality of lung deflation.
Double-lumen endotracheal tubes (DL-ETT) and bronchial blockers (BB) have both been used for lung isolation in video-assisted thoracic surgery (VATS). Though not well studied, it is widely thought that a DL-ETT provides faster and better quality lung collapse. The aim of this study was to compare a BB technique vs a left-sided DL-ETT strategy with regard to the time and quality of lung collapse during one-lung ventilation (OLV) for elective VATS. ⋯ The time and quality of lung collapse during OLV for VATS was significantly better when using a BB than when using a left-sided DL-ETT. Surgeons could not reliably determine which device was being used based on the time and quality of lung collapse. This trial was registered at ClinicalTrials.gov number, NCT01615263.
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Comparative Study Observational Study
Comparing success rates of anesthesia providers versus trauma surgeons in their use of palpation to identify the cricothyroid membrane in female subjects: a prospective observational study.
The primary aim of this study was to compare the success rates of anesthesia providers vs trauma surgeons in their use of palpation to identify the cricothyroid membrane (CTM). The secondary aim was to explore whether prior training and experience performing surgical airways affected the success rates for identifying the CTM. ⋯ The success rates for identifying the CTM using palpation were low and not significantly different for anesthesia providers and surgeons, collectively, as well as for the various levels of training. Anesthesiologists' ability to mark the CTM location correctly did not improve with years of experience.
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Mentorship has been shown to improve career satisfaction, research productivity, and retention of academic physicians. There is a current lack of studies investigating factors that either promote or hinder effective mentoring relationships through the perspectives of both faculty and residents. The aim of this study was to ascertain these factors and subsequently to provide guidance on designing residency mentorship programs. ⋯ We identified three key factors that facilitate or hinder mentorship relationships and proposed solutions for designing effective mentorship programs for postgraduate training programs.
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Observational Study
Dosing and efficacy of intranasal dexmedetomidine sedation for pediatric transthoracic echocardiography: a retrospective study.
We designed this retrospective observational study on the use of α2-agonist dexmedetomidine to determine the optimum intranasal dose to achieve sedation for pediatric transthoracic echocardiography and to identify any dose-related adverse effects. ⋯ We found that aerosolized intranasal dexmedetomidine offers satisfactory conditions for TTE in children three months to three years of age with an optimal dose of 2.5-3.0 µg·kg(-1)administered under the supervision of a pediatric cardiac anesthesiologist.