ROTATION: Veterans Administration Staff Assistant Rotation (VAST) 
TYPE: Required or elective 
DURATION: 1 month
FACULTY:  Robert R. Kirby, MD

PREREQUISITES: CA-3 Level Rotation Only
GENERAL GOALS: 

In addition to all goals and objectives stated for General VA OR Rotation, the following also apply:
This rotation is intended as a transition to practice rotation.  While faculty will always be immediately available for consultation and assistance, residents are expected to function at an independent consultant level for all types of anesthesia cases (which may be any type at the discretion of the rotation director) assigned to them by the rotation director.   Preoperative evaluations and planning will be either done or assessed by the resident independently.  Residents will still present cases to attendings, but it is expected that the attending physician should not have to ask for more preoperative information or have significant input into the anesthetic planning.  Residents are expected to function at an independent consultant level in all aspects of anesthesia practice - preoperative evaluation, intraoperative management, and postoperative care.  While faculty are immediately available for consultation and assistance, it is expected that in most cases, faculty will have only an observational role.

PATIENT CARE SKILLS:   The CA-3 resident on this rotation will develop:

  • Consultative independent level performance of preoperative evaluation and development of
    anesthetic plan
  • Consultative independent level performance of intraoperative management - including choice and
    management of technique, performance of all necessary anesthesia related procedures, placement
    and monitoring of invasive monitors, communication and interaction with the surgical and nursing
    teams
  • Consultative independent level management of postoperative care - shows appropriate judgment
    for extubation and appropriate recovery care (including level of care - i.e. PACU or ICU), pain
    management, management of anesthetic, surgical, and medical postoperative complications

MEDICAL KNOWLEDGE

  • See basic General OR Rotation
  • Anesthesia related knowledge to support independent consultant level practice

Interpersonal and Communication Skills, Professionalism, Practice-Based Learning, Systems-Based Practice:

Evaluation to Determine Goal Achievement 

  • You are evaluated every week by all attendings who worked with you using our online evaluation
    system. The attending physicians complete a Departmental Resident Evaluation Form, which are
    reviewed quarterly by the Clinical Competence Committee and continuously by the program director.  Your advisor informs you of any problems identified, and serious problems will be discussed with you immediately after they occur. 
  • You will complete a Departmental Online Rotation Evaluation Form. 
  • The Program Director will evaluate the results of the In-Training Examination for the American Board of Anesthesiologists (ABA) in general and for areas of departmental weakness. Consistent
    weaknesses may result in adjustment of the above goals. 

Teaching Resources to Accomplish the Objectives 

  • Approximately 4000 patients per year, primarily patients >45 years of age from the following surgical services:
    • General surgery
    • Neurologic surgery
    • Ophthalmologic Surgery
    • Orthopedic Surgery
    • Otolaryngology 
    • Plastic surgery
    • Urologic surgery
    • Vascular surgery
    • Cardiothoracic surgery
  • Textbooks: 
    • Miller RD, ed. Anesthesia, 5th ed. 
    • Kirby RR, Gravenstein N, eds. Clinical Anesthesia Practice, 2nd ed.
    • Barash PG, ed. Clinical Anesthesia, 4th ed. 
  • Faculty
    • Otto Albuschat, MD
    • Charles Gibbs, MD
    • Robert R. Kirby, MD (Chief) 
    • Emilio Lobato, MD
    • Segudina Saga-Rumley, MD (Pain Management)  
    • Raymond Schultetus, MD
    • Cheri A. Sulek, MD 
    • Felipe Urdaneta, MD
  • Dr. Kirby is the faculty member responsible for the rotation.

RETURN TO INDEX FOR GOALS AND OBJECTIVES
Revised 7/2005