1.Evaluating nontechnical skills training in anesthesia: A scoping review of methodologies and implementation challenges for the past decade (2015-2025).
Mary Ellen Chiong PEREZ ; Anthony Relucio PEREZ
Philippine Journal of Anesthesiology 2025;30(1):5-13
BACKGROUND
Nontechnical skills (NTS) such as communication, teamwork, leadership, situation awareness, and decision-making are crucial for patient safety in anesthesia practice. Despite growing recognition of their importance, implementation of structured NTS training in anesthesia education remains variable.
OBJECTIVEThis scoping review aims to map the current landscape of NTS training approaches in anesthesia residency programs globally over the past decade (2015–2025) to identify implementation patterns, assessment methodologies, and gaps in existing programs.
METHODOLOGYFollowing Arksey and O’Malley’s framework and PRISMA guidelines, a systematic search was conducted across PubMed, Scopus, and Google Scholar. Studies focusing on NTS training in anesthesia education published between January 2015 and February 2025 were included. Two-phase study selection involved title/abstract screening followed by full-text review with standardized criteria. Data regarding training approaches, assessment methods, and outcomes were extracted and analyzed.
RESULTSTen studies from eight countries met the inclusion criteria. Simulation-based training was the predominant educational approach (7/10 studies), with the anesthetists’ NTS framework being the most commonly utilized assessment tool. Teamwork, situation awareness, and decision-making were the most frequently targeted skill domains. Significant variability was observed in implementation approaches, ranging from isolated workshops to longitudinally integrated curricula.
CONCLUSIONWhile progress has been made in incorporating NTS into anesthesia training, notable gaps persist in longitudinal integration, cultural adaptation, and standardized assessment. Future research should focus on developing structured, evidence-based curricula to enhance patient safety outcomes.
Human ; Patient Safety ; Simulation Training
2.Evaluating nontechnical skills training in anesthesia: A scoping review of methodologies and implementation challenges for the past decade (2015-2025).
Mary Ellen Chiong PEREZ ; Anthony Relucio PEREZ
Philippine Journal of Anesthesiology 2025;30(1):5-13
BACKGROUND
Nontechnical skills (NTS) such as communication, teamwork, leadership, situation awareness, and decision-making are crucial for patient safety in anesthesia practice. Despite growing recognition of their importance, implementation of structured NTS training in anesthesia education remains variable.
OBJECTIVEThis scoping review aims to map the current landscape of NTS training approaches in anesthesia residency programs globally over the past decade (2015–2025) to identify implementation patterns, assessment methodologies, and gaps in existing programs.
METHODOLOGYFollowing Arksey and O’Malley’s framework and PRISMA guidelines, a systematic search was conducted across PubMed, Scopus, and Google Scholar. Studies focusing on NTS training in anesthesia education published between January 2015 and February 2025 were included. Two-phase study selection involved title/abstract screening followed by full-text review with standardized criteria. Data regarding training approaches, assessment methods, and outcomes were extracted and analyzed.
RESULTSTen studies from eight countries met the inclusion criteria. Simulation-based training was the predominant educational approach (7/10 studies), with the anesthetists’ NTS framework being the most commonly utilized assessment tool. Teamwork, situation awareness, and decision-making were the most frequently targeted skill domains. Significant variability was observed in implementation approaches, ranging from isolated workshops to longitudinally integrated curricula.
CONCLUSIONWhile progress has been made in incorporating NTS into anesthesia training, notable gaps persist in longitudinal integration, cultural adaptation, and standardized assessment. Future research should focus on developing structured, evidence-based curricula to enhance patient safety outcomes.
Human ; Patient Safety ; Simulation Training
3.Evaluating nontechnical skills training in anesthesia: A scoping review of methodologies and implementation challenges for the past decade (2015-2025).
Mary Ellen Chiong PEREZ ; Anthony Relucio PEREZ
Philippine Journal of Anesthesiology 2025;30(1):5-13
BACKGROUND
Nontechnical skills (NTS) such as communication, teamwork, leadership, situation awareness, and decision-making are crucial for patient safety in anesthesia practice. Despite growing recognition of their importance, implementation of structured NTS training in anesthesia education remains variable.
OBJECTIVEThis scoping review aims to map the current landscape of NTS training approaches in anesthesia residency programs globally over the past decade (2015–2025) to identify implementation patterns, assessment methodologies, and gaps in existing programs.
METHODOLOGYFollowing Arksey and O’Malley’s framework and PRISMA guidelines, a systematic search was conducted across PubMed, Scopus, and Google Scholar. Studies focusing on NTS training in anesthesia education published between January 2015 and February 2025 were included. Two-phase study selection involved title/abstract screening followed by full-text review with standardized criteria. Data regarding training approaches, assessment methods, and outcomes were extracted and analyzed.
RESULTSTen studies from eight countries met the inclusion criteria. Simulation-based training was the predominant educational approach (7/10 studies), with the anesthetists’ NTS framework being the most commonly utilized assessment tool. Teamwork, situation awareness, and decision-making were the most frequently targeted skill domains. Significant variability was observed in implementation approaches, ranging from isolated workshops to longitudinally integrated curricula.
CONCLUSIONWhile progress has been made in incorporating NTS into anesthesia training, notable gaps persist in longitudinal integration, cultural adaptation, and standardized assessment. Future research should focus on developing structured, evidence-based curricula to enhance patient safety outcomes.
Human ; Patient Safety ; Simulation Training
4.Anesthetic management in bilateral deep brain stimulation for X-linked Dystonia Parkinsonism: Early single institution experience from the Philippines
Mary Ellen Chiong-Perez ; Cid Czarina E. Diesta ; Jean Quint L. Oropilla
Acta Medica Philippina 2020;54(2):203-209
X-linked dystonia-parkinsonism (XDP) is a rare, adult-onset, progressive, hereditary neurological movement disorder primarily affecting Filipino men with maternal families from Panay province of the Philippines. Medical treatment modalities currently being used have offered temporary symptomatic relief. Surgical management in the form of bilateral globus pallidi internae (Gpi) deep brain stimulation (DBS) has shown promising results and is increasingly being performed in advanced centers, as reported in international literature. Presented herein is the local experience of seven (7) retrospectively reviewed cases from February 2018 to February 2019 in a tertiary center in the Philippines with a particular focus on anesthetic management. All patients were male, from Panay, and presented with progressive dystonia and parkinsonism. All patients underwent planned bilateral, simultaneous DBS electrode, and implantable pulse generator (IPG) placement performed by a multidisciplinary team. Anesthetic management consisted of Bispectral Index (BIS) guided conscious sedation with low dose propofol and remifentanil infusions with a complete scalp nerve block (SB) at the start of the procedure then shifted to awake monitored anesthesia care during electrode placement, microelectrode recording (MER) and macro stimulation testing. All were put under general anesthesia with a supraglottic airway device during the placement of the internal pulse generator (IPG) in the infraclavicular area. All seven patients had successful localization, and insertion of the DBS electrode and discharged improved. The anesthetic management of the DBS used in these cases warrants further investigation and may lead to standardization of future practice.
Deep Brain Stimulation
5.Congenital oval window aplasia: An unusual cause of conductive hearing loss in an adult.
Charlotte M. Chiong ; Rachel T. Mercado-Evasco ; Alessandra E. Chiong ; Mary Ellen C. Perez ; Franco Louie L. Abes ; Abner L. Chan
Philippine Journal of Otolaryngology Head and Neck Surgery 2016;31(1):39-44
OBJECTIVES: To report a case of congenital oval window aplasia (COWA) in a Filipino adult presenting with unilateral maximal conductive hearing loss and discuss the diagnostic considerations, pathophysiology and management.
METHODS:
Design: Case Report
Setting: Tertiary Public Referral Center
Patient: One
RESULTS: Audiometric evaluation showed a maximal unilateral left conductive hearing loss. High resolution temporal bone CT showed absence of the oval window on the left along with facial and stapes abnormalities. Exploratory tympanotomy showed an aberrant facial nerve, monopodal and abnormally located stapes and absent oval window. Postoperative hearing gain achieved after a neo-oval window and Schuknecht piston wire prosthesis remained stable over two years.
CONCLUSION: A congenital minor ear anomaly classified as Cremers Class 4a in which a congenital oval window aplasia was associated with an aberrant facial nerve anomaly and a monopodal stapes is reported. Recent literature supported the view that congenital oval window aplasia can in selected cases be amenable to various surgical approaches and a stable postoperative hearing gain is achievable in the long term.
Human ; Male ; Female ; Adult ; Ear, Middle ; Hearing


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