NeuroAnesthesia Skills Boot Camp in progress at the SNAAC annual meeting.

NeuroAnesthesia Skills Boot Camp in progress at the SNAAC annual meeting.

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In today's evolving landscape, the world of academic medicine is confronted with the question of how to master the complexities of modern teaching and relearn practical strategies to meet the needs of younger learners. This issue of the ASA Monitor is dedicated to exploring comprehensive solutions to this conundrum that are rooted in rigorous research. The following articles promise to enrich educators with a diverse array of insights from leading experts, enhancing the effectiveness of those committed to teaching and training. Education in anesthesiology continues to integrate new facets as technological advances and globalization open novel portals for advancement. Here, we delve into academic mentorship, viewing it through the lens of both faculty and residents, international collaboration in education, and cutting-edge technologies in education, such as online learning, educational apps, podcasts, and virtual reality. The authors highlight optimization of the learning environment for underrepresented trainees, boosting medical student interest in anesthesiology, and leveraging these pieces of the puzzle to refine anesthesiology education for the next generations.

Drs. Wald, Helou, and Azocar spotlight academic mentorship and describe its indispensable role in academia. Their article prompts reflection on the value placed on mentorship within departments and the structure of existing programs. They advocate for a mentorship model that is both supportive and rigorous, fostering independence while providing candid but constructive feedback. The authors distinguish between mentorship and sponsorship, highlighting sponsorship's critical role in career advancement through advocacy.

Crises management simulation in progress. ABG data was used as a training reference, and the computerized manikin is utilized for simulation training purposes. Picture courtesy of SIMTAC, Singapore. Photo taken at the 18th World Congress of Anaesthesiologists, Singapore, March 2024.

Crises management simulation in progress. ABG data was used as a training reference, and the computerized manikin is utilized for simulation training purposes. Picture courtesy of SIMTAC, Singapore. Photo taken at the 18th World Congress of Anaesthesiologists, Singapore, March 2024.

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Education is often called “the great leveler,” but online education could indeed be the “greater leveler.” Online learning has many advantages. It gives learners a safe space for elaborative learning and reflection in a flexible time schedule. Through this rosy visage, a glimmer of truth, however, shines through. In their feature article, Drs. Nanners, Nemergut and Kohli note that although technology and hybrid learning are here to stay, their integration into graduate medical education (GME) is not without issues. The internet is a quagmire where truths and untruths lie, and they indicate that questions abound regarding the validity and reliability of online resources. They express concerns that without robust mechanisms for fact-checking and peer review, there is legitimate danger of incorporating unverified content into the program, potentially compromising the quality of the medical curriculum. The pandemic ushered in a new era of online learning and “technology-integrated teaching.” Institutions at all levels of education are grappling with the Shakespearean “to be or not to be” hybrid. Online learning should evaluate the learners' preexisting knowledge and views on the subject. Feedback should be incorporated. However, online learning is prone to distraction, perhaps due to lack of supervision. Hence, content should be made as compelling and engaging as possible by incorporating various types of media like quizzes, interviews, surveys, debates, and constructive controversy.

Podcasts, online knowledge bases, and question banks help residents of different programs with variable, difficult schedules gain similar knowledge and even prepare for board exams, often while working or doing daily chores. Sophi Wu and Dr. Wolpaw discuss the role of podcasts in education: expert opinion, curated lessons, and temporal topics all at the tip of a finger. In different studies, Drs. Kelly, Wolpaw, and Vasilopoulos have shown superior or at least equivalent learning through podcasts compared to didactic teaching (Acad Med 2022;97:1079-85; Cureus 2022;14:e31289; Anesth Analg 2015;121:791-7). ASA produces its own podcast series, “Central Line,” that serves to spread the society's message to its members and community.

Drs. Guruswamy, Uribe-Marquez, and Mitchell talk about the role of virtual reality (VR) in anesthesia education. They state that VR enhances skill development and learning by providing an immersive, engaging environment that facilitates superior learning outcomes. The authors describe its advantages, including cost-effectiveness, quantification of trainee performance, and real-time feedback for improvement with customizable learning goals. Different methods are available, such as a computer screen-based system to create an immersive field or 3D simulation using a head mount. Simulation and VR are indeed poised for significant expansion and evolution.

Advances in technology have rendered borders virtual, with educational initiatives bringing the world closer every day. International collaboration is presented as a key driver for the development of anesthesiology subspecialties, with neuroanesthesiology serving as a prime example of how global accreditation of the neuroanesthesiology fellowship and standardization of education can lead to improved patient care worldwide. The International Council for Perioperative Neuroscience Training (ICPNT) champions collaborative education and research that could potentially lead to future innovations. Drs. Rajan and Kofke review the role of international collaboration in accreditation of the neuroanesthesiology fellowship and in support of perioperative neuroscience research, education, and clinical improvement. The ICPNT has the participation of 38 programs from North America, South America, the United Kingdom, Europe, Asia, Australia, and the Middle East that provide infrastructure support for interprogram education and quality improvement.

In their article on academic mentorship, Drs. Jin, Humeidan, Schabel, Costa, and Bergese argue that formalized academic mentorship is indeed crucial to resident development. They delineate the obstacles to resident scholarly development, including time, appropriate project allocation, faculty mentorship, and administrative issues. They also differentiate between mentorship and a sponsor-protégé relationship wherein reputational capital is used to advance the protégé. This is of particular importance in the advancement of underrepresented minorities, they say.

Drs. Otto, Ng, Lewis, and Theard focus on underrepresented minorities in their article on diversity in mentorship and education. They describe the need to build institutional capacity for diversity, and they explore social interactions, organizational cultures, and physical and virtual spaces that shape learner experiences. There is often a less-than-positive experience for underrepresented trainees. The authors go on to delineate strategies for tackling burnout, “imposter syndrome,” and attrition. Underrepresented minorities are crucial to our communities, and it has been well documented that they often return to their own communities to practice, thus contributing greatly to social health care equity (asamonitor.pub/3TPxCSd).

In 2020, there were 53,804 anesthesiologists practicing in the U.S., with an average age of 52.6 years. And around 45% of anesthesiologists were older than 55, which implies that by 2030 there will be a marked shortage of anesthesiologists unless more medical graduates enter our specialty (asamonitor.pub/449pnoZ). Drs. Vanga and Rihani reveal an interesting fact: according to data from the Association of American Medical Colleges in 2020, nearly 60% of residents matching into anesthesiology did not name it as their first preference. They also reference a Loyola Stritch School of Medicine survey that found many medical students were unaware of the important role anesthesiologists play in the OR. The authors emphasize that early anesthesia rotations, airway workshops, and peer (resident) mentorships could encourage future applications in anesthesia residency. They also note that, per a Stanford University initiative, these peer mentoring strategies have been shown to increase specialty exposure. Such strategies, along with expansion of the elective anesthesia curriculum as per Society for Education in Anesthesia guidelines, resulted in a three-fold increase in interest and applicants over a five-year period.

The following articles offer a comprehensive exploration of education in anesthesiology and present valuable perspectives and strategies for enhancing educational practices, which we hope will ultimately help to foster a more inclusive, innovative, and effective academic environment. This issue of the Monitor aims to educate you about how education in our specialty is changing – and what still needs to be changed. We invite you to read on and be a part of the change!

Shobana Rajan, MD, FASA, Staff Anesthesiologist, Program Director for the Neuroanesthesia Fellowship, Cleveland Clinic Multispecialty Anesthesia, Board of Directors, Society for Neuroscience in Anesthesiology and Critical Care (SNACC), and Chair, International Council for Perioperative Neuroscience Training (ICPNT).

Shobana Rajan, MD, FASA, Staff Anesthesiologist, Program Director for the Neuroanesthesia Fellowship, Cleveland Clinic Multispecialty Anesthesia, Board of Directors, Society for Neuroscience in Anesthesiology and Critical Care (SNACC), and Chair, International Council for Perioperative Neuroscience Training (ICPNT).

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Lalitha Sundararaman, MD, FASA, Anesthesiologist, Harvard Medical School, Founder and Member, Prana Institute of Holistic Medicine, Boston, Massachusetts.

Lalitha Sundararaman, MD, FASA, Anesthesiologist, Harvard Medical School, Founder and Member, Prana Institute of Holistic Medicine, Boston, Massachusetts.

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