Educational perspectives in cardiothoracic anesthesia in the United States using a survey of educators and learners

Abstract

Background: Cardiothoracic anesthesiology training presents learners with unique challenges, procedural skills, and the management of high-intensity critical scenarios. An effective relationship between educator and learner can serve as the backbone for effective learning, which is crucial for the development of budding anesthesiologists. Strengthening this educational alliance between teachers and trainees involves understanding the educational values educators and learners find most important to their learning experiences. This study aimed to identify the key educational values related to cardiothoracic anesthesia for both learners and educators. By identifying these values in separate cohorts (learners and educators), the importance of various educational values can be examined and compared between the trainees and teachers.

Methods: Two separate surveys (one for learners and one for teachers) were adapted from the Pratt and Collins Teaching Perspectives Inventory to establish the importance of various educational values related to cardiothoracic anesthesia. Surveys were sent to 165 Accreditation Council for Graduate Medical Education-accredited anesthesiology residency training programs in the United States to trainees (residents and cardiothoracic anesthesiology fellows) and educators (board-certified cardiothoracic anesthesiologists).

Results: Analysis of survey results from 19 educators and 57 learners revealed no statistical differences across the two groups, except Q15: "Let trainee perform critical technical steps" (P value = 0.02).

Conclusions: While learners and educators in cardiothoracic anesthesia hold similar values regarding cardiac anesthesia education, they differ in the degree to which critical technical steps should be performed by learners.

Keywords: Anesthesia, cardiac; Anesthesia, cardiac procedures; Fellowships and scholarships; Graduate medical education; Internship and residency; Thoracic surgery.

Fig. 1.

Overall composite results. Red: learner, blue: educator. (A) Learning environment: average score of Q1, 3, 4, and 5. (B) Learner engagement: average score of Q7–Q11. (C) Session management: average score of Q12–Q16. (D) Teaching methods: average score of Q17–Q24.

Fig. 2.

Learning environment. Red: learner, blue: educator, Q1: Get to know the trainee as a person/individual. Q3: Specify what is expected of me for each case. Q4: Encourage me to ask questions and voice any uncertainty. Q5: Allow for progressive trainee autonomy.

Fig. 3.

Learner engagement. Red: learner; blue: educator, Q7: model respectful attitude toward the patient, Q8: model respect for all care team members, Q9: discuss rationale/evidence for operative decision making, Q10: discuss cases pre-operatively with trainee, Q11: ask trainee to describe course of anesthetic.

Fig. 4.

Learning environment. Red: learner, blue: educator, Q12: address potential intraoperative pitfalls, Q13: review salient studies, Q14: demonstrate technical steps, Q15: trainee perform critical technical steps, Q16: provide immediate feedback. ^*P value < 0.05.

Fig. 5.

Learning environment. Red: learner, blue: educator. Q17: refer to literature to support decisions, Q18: discuss topics relevant to the case, Q19: provide clear verbal instructions, Q20: demonstrate tolerance and patience, Q21: collaborative decision making, Q22: discuss case post-operatively, Q23: provide specific examples of what the trainee did well and what he/she needs to improve, Q24: make explicit plan for further learning.