Learning curves for three specific procedures by anesthesiology residents using the learning curve cumulative sum (LC-CUSUM) test.
10.4097/kjae.2017.70.2.196
- Author:
Gregoire WEIL
1
;
Cyrus MOTAMED
;
David J BIAU
;
Marie Laurence GUYE
Author Information
1. Department of Anesthesia, Institute Gustave Roussy, Villejuif, France. cyrus.MOTAMED@gustaveroussy.fr
- Publication Type:Original Article
- Keywords:
Anesthesiology residency;
Cumulative sum;
Epidural;
Intubation;
Learning curve;
Tracheal puncture
- MeSH:
Analgesia, Epidural;
Anesthesia;
Anesthesiology*;
Intubation;
Learning Curve*;
Learning*;
Punctures;
Risk Adjustment;
Tea;
Ventilation
- From:Korean Journal of Anesthesiology
2017;70(2):196-202
- CountryRepublic of Korea
- Language:English
-
Abstract:
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.
