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KMID : 0356920170700020196
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Korean Journal of Anesthesiology
2017 Volume.70 No. 2 p.196 ~ p.202
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Learning curves for three specific procedures by anesthesiology residents using the learning curve cumulative sum (LC-CUSUM) test
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Weil Gregoire
Motamed Cyrus
Biau David J
Guye Marie Laurence
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Abstract
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Background: The learning curve cumulative sum (LC-CUSUM) test is an innovative tool that allows quantitative monitoring of individual medical performance during the learning process by determining when a predefined acceptable level of performance is reached. This study used the LC-CUSUM test to monitor the learning process and failure rate of anesthesia residents training for specific subspecialty anesthesia procedures.
Methods: The study included 490 tracheal punctures (TP) for jet ventilation, 340 thoracic epidural analgesia (TEA) procedures, and 246 fiberoptic nasal intubations (FONI) performed by 18 residents during their single 6-month rotation.
Results: Overall, 27 (14?52), 19 (5?41), and 14 (6?33) TP, TEA, and FONI procedures were performed, respectively, by each resident. In total, 2 of 18 residents achieved an acceptable failure rate for TEA according to the literature and 4 of 18 achieved an acceptable failure rate for FONI, while none of the residents attained an acceptable rate for TP.
Conclusions: A single 6-month rotation in a reference teaching center may not be sufficient to train residents to perform specific or sub-specialty procedures as required. A regional learning network may be useful. More patient-based data are necessary to conduct a risk adjustment analysis for such specific procedures.
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KEYWORD
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Anesthesiology residency, Cumulative sum, Epidural, Intubation, Learning curve, Tracheal puncture
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