| Department of Anesthesiology at UF |
| Unique Educational Opportunities at UF |
A team of faculty members and engineers has developed an operational anesthesia simulator that is used to teach residents in anesthesiology in much the same way that simulators are used to teach astronauts and pilots. Using a mannequin, a fully functional anesthesia machine complete with monitors, computer hardware and software, and educational ideas from the faculty, the anesthesia simulator has become an integral part of the early training of our residents. The mannequin has been constructed to simulate an actual patient. It breathes, produces carbon dioxide, consumes oxygen, has breath sounds and heart sounds, has blood pressure, pulse, oxygen saturation, and responds to neuromuscular stimulation as a real patient would. New residents can develop basic skills in induction, maintenance and reversal of anesthesia, monitoring, and operation of the anesthesia machine far more rapidly and safely than when traditional methods of teaching are used. In addition, more advanced residents learn to diagnose and treat simulated problems that occur only rarely during anesthesia but are life-threatening when they do (e.g. malignant hyperthermia, selected anesthesia machine malfunctions). More advanced simulations also form part of the problem-based learning curriculum which runs parallel to the basic lecture series at 7:00 a.m. A pediatric simulator has recently been added to our simulation center.
Elective rotations in cardiovascular and neurologic monitoring techniques are available
to our CA3 residents. During these electives, residents spend time learning about
transesophageal echocardiography or several types of neurologic monitoring, depending on their interests. Residents choosing transesophageal
echocardiography learn to perform and interpret transesophageal echocardiography
(TEE). A TEE simulator has a large database of normal and abnormal TEE findings
and is part of a teaching program that will help the resident learn about TEE.
There are many patients who are monitored with TEE including patients undergoing
any type of surgery but principally cardiovascular and vascular surgery. Our
department has an excellent relationship with the health center's cardiologists,
who help with both teaching and interpretation of TEE. All of our cardiovascular
faculty and even some recent resident graduates have achieved certification
in this monitoring modality. Those residents interested in neurologic monitoring
learn to perform and interpret basic electroencephalographic and multimodality
evoked potential monitoring of anesthetized patients undergoing neurologic,
vascular or orthopedic surgery. The intraoperative evoked potential laboratory
employs three fully certified technologists who help in the training of residents.
Between five and ten cases are monitored each week including carotid endarterectomies,
intracranial aneurysm clippings, spine reconstructions, repair of aortic coarctation,
Jannetta procedures, acoustic schwannoma resections, and many others. A new
addition to this elective involves transcranial electrical motor evoked potential monitoring which presents significant anesthetic challenges.
Our preoperative evaluation clinic features a totally
computerized preoperative evaluation system. This Windows-based system
is used to produce preoperative medical records on all patients evaluated
in our preoperative evaluation clinic (approximately 75% of all patients
undergoing surgery at Shands Hospital). This easy-to-use system, which
is very popular with residents and faculty, allows rapid retrieval of prior
anesthetic evaluations when patients present for surgery that greatly facilitates
the current preoperative evaluation. In addition, the preoperative system
is linked directly to the hospital medical information system giving immediate
access to laboratory information, X-ray reports, EKG reports, etc. This
system allows the resident to spend more time evaluating the patient and
learning about anesthetic considerations for a particular operation or
medical condition and less time trying to find old records and lab results.
In addition, the preoperative system is directly linked to an on-line medical
text that is being developed to allow residents immediate access to information
about the appropriate preoperative evaluation of patients with various
medical conditions (e.g. diabetes, cervical spine disease, coronary artery
disease, hypertension and many others). Preoperative evaluation of patients
has shifted nearly completely from an inpatient to an outpatient basis
in the last decade, and this system was developed to meet the challenges
that this change imposes.
| SUBSPECIALTY ROTATIONS |
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Last updated 8/31/2007