Anesthesiology

Course #: 880J

Title:  Anesthesiology and Perioperative Medicine

Selective Director(s):  Latha Hebbar , M.D.

Maximum Number of students per block: 2

LEARNING GOALS AND OBJECTIVES:
At the completion of this clinical rotation, students will be able to:

1. Discuss cardiovascular and pulmonary physiology as applied in a variety of clinical settings and disease processes.
2. Discuss clinically applicable pharmacokinetics and pharmacodynamics across various pharmacologic therapies.
3. Start an intravenous line and have been guided through the process of intubation, starting an arterial line, and central venous access.
4. Discuss the treatment of acute pain through various modalities, including oral, intravenous, neuraxial, and regional.techniques, as well the ethics involved in the treatment of pain.
5. Communicate basic ACLS principles, with particular attention placed on airway management.
6. Demonstrate professional behavior in pre-operative encounters with patients and their families, understanding the stress and anxiety involved in this period.

TEACHING METHODOLOGIES AND ROTATION ACTIVITIES:
Students on this rotation will be expected to learn and achieve the educational goals and objectives through the following methodologies and activities:

1. Participation in weekly assignments in the operating rooms with one week to be spent in each of the following: cardiothoracic, obstetrics, and general operating room cases.
2. Attendance at weekly didactics, including Tuesday morning conference and the weekly lecture series for 1st-year Anesthesia Residents, as well as specific didactics for obstetrics (OB) or cardiothoracic (CT) anesthesia for the assigned week.
3. Completion of two nights of call in the main operating rooms with an upper level and junior anesthesia resident.
4. Completion of assignment to read two chapters each week to cover aforementioned goals (cardiovascular, pulmonary, pharmacology, airway management) and those which are covered in the residency lecture series each week.
5. Review of arterial blood gas (ABG) interpretation and treatment of various physiologic derangements able to be diagnosed from an ABG.
6. Attendance 2-3 simulation conferences during the rotation during which they will learn airway management and IV skills, as well as run through real-time computer-simulated ACLS-type patient encounters that are conducted on SimMan, an interactive, automated mannequin that simulates a variety of medical scenarios.

PATIENT ENCOUNTERS
Students on this rotation will be expected to work up and/or follow the following minimum number of patients with the specified conditions (i.e, 2 pediatric ear infections, 2 adult migraine headaches):

1. 4 patients undergoing surgery for cardiovascular disease. Student will delineate specific lesion to be fixed and understand anesthetic goals for safe patient management.
2. 4 patients undergoing labor epidural or c-section. Student will delineate major physiologic changes with pregnancy and understand anesthetic goals for safe patient management in normal term parturient and in the pre-eclamptic patient.
3. 2 patients undergoing surgery related to trauma. Student will delineate specific injury to be fixed and understand anesthetic goals for safe patient management in the setting of trauma.
4. 1 patient of their choice from their general OR week who had an interesting pathology or learning point (i.e., difficult airway management, anesthetic management related to specific disease process unrelated to particular surgery, etc)

EVALUATION AND FEEDBACK:
Students on this rotation will be evaluated through the following methods, and designate by whom for each method:

1. Direct observation of clinical skills performance by residents each day and discussion of didactic/reading topics, with application to daily clinical cases.
2. Direct observation of clinical skills and intraoperative discussion of didactic knowledge by one attending from the cardiothoracic service and one attending from the OB service.
3. Completion of a 25 question quiz at the end of the rotation which will cover general principles that should be mastered during the month.

Please outline when and how the learners will receive feedback on their performance:
Students will receive feedback following participation in clinical care activities from the residents and designated attendings.