Clinical Teaching: A Guide to Teaching Practical Anaesthesia. Edited by David Greaves, Chris Dodds, Chandra M. Kumar, and Berend Mets. Lisse, Swets & Zeitlinger, 2003. ISBN 9026519419. Pages: 275. Price: $108.90.
Clinical Teaching: A Guide to Teaching Practical Anesthesia is probably a first in terms of its specific content. There are books about simulators in anesthesiology, how to survive an anesthesia training program, and how to manage a department of anesthesiology. There are certainly other general books about how to teach medicine to medical students or residents. However, I am unaware of available texts that comprehensively address the mechanics of teaching clinical anesthesiology. It may, therefore, be a unique addition to the anesthesia department library.
The premise of this book is that all consultants in anesthesiology are experts in their respective fields (e.g. , anesthesia subspecialties) but may not necessarily possess the innate talent to share knowledge and clinical expertise effectively and efficiently. Every anesthesiologist's teaching skills can be improved by incorporating some thought and preparation before arriving in the operating room, but educators may not be inclined to do this because the resident learning arena is informal. The book suggests that those who teach residents should put the same amount of effort into preparing to teach in the operating room as if they were giving a formal lecture. It seeks to show educators how to structure their clinical teaching such that it makes the lessons learned more relevant to each individual learner. However, the book is directed not only towards anesthesia educators, but to anesthesia learners as well, as the book advocates the philosophy that a professional career is a lifetime of learning, and that trainees need to “learn to learn.”
The book is divided into three sections (with multiple chapters in each section), entitled “Setting the Scene for Learning,”“Clinical Teaching,” and “Using Simulators for Teaching.” Two appendixes are included at the end that discuss how to moderate a problem-based learning session (which is somewhat redundant because there is also a separate chapter on problem-based learning) and an actual clinical scenario taken from a problem-based learning refresher session presented at the Annual Meeting of the American Society of Anesthesiologists that includes sample questions and answers.
The chapters in the first section focus on the resources needed by the educator to provide the trainee with good clinical training. Topics in this section include departmental support of a learning environment, supervision of residents, how residents learn from work, clinical competence, teaching nontechnical skills, problem-based learning, mentoring, and portfolio maintenance (from the standpoint of both educators and residents). This section also gives advice to trainees on how to be less dependent on their instructors and more proactive regarding their own education in each chapter. For example, the chapter about assessment of clinical competence includes a section on self-assessment for the resident. The chapter regarding the ethics of learning on patients will be of interest not only to educators and residents but perhaps also to patients and their families. The chapter on the use of portfolios may be useful to those anesthesia program directors facing recent Accreditation Council for Graduate Medical Education mandates regarding this very topic. At a time when the Accreditation Council for Graduate Medical Education has recently revised standards for how all residents should learn and how their learning should be assessed, this book may be a welcome addition to help anesthesia educators navigate the Accreditation Council for Graduate Medical Education toolbox and understand “competencies.” The Accreditation Council for Graduate Medical Education has recently endorsed six general competencies for all residents, regardless of their specialty (patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice). This section may help educators augment their transition to this new way of teaching and assessment.
The second section focuses on topics such as intraoperative teaching, developing decision-making skills, professionalism, judging clinical competency, and providing feedback. There is a fair amount of overlap and redundancy between the first and second sections of the book, but overall the two sections provide a wealth of useful information.
The third section on the use of simulators in anesthesia education also includes information about the value of role-playing in anesthesia (whether you have a simulator or not) and how to run mock emergency “fire drills” as well. It is likely that much of the information in this section can also be found in other anesthesia texts on simulators, but the section goes beyond simulators to discuss the function of other teaching methods for those departments which do not have a simulator available.
This book has a definite British influence. All of the editors except one (Professor Mets) are British, and only three of the 12 contributors are from the United States, so there is a definite bias toward the British style of education. However, the lone editor from the United States, Professor Berend Mets, M.B., Ph.D., is the current president of the Society for Education in Anesthesia (Park Ridge, Illinois) an organization devoted to fulfilling the needs of anesthesia educators by expanding their medical education knowledge and skill base and assisting in the planning of educational programs.
I very much enjoyed the style of the book. Its concepts come to life and are enjoyable to read through devices such as medically related cartoons scattered liberally throughout the book (the price of the book is almost worth it for the cartoons alone). Chapters are short, concise, and to the point, and major points are summarized and highlighted in boxes throughout each chapter, making salient points easy to identify. Overall, anesthesia residents and educators alike will find this a useful, common sense approach to anesthesia education. Information on this topic is scarce; until another book like this becomes available, it stands in a class by itself.
Mayo Graduate School of Medicine, Mayo Clinic, Rochester, Minnesota. barnes.roxann@mayo.edu
