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Elective Title: 93AN780 — ADVANCED CLINICAL ANESTHESIA

Description:

This ACE is designed for students seriously considering a career in the specialty of anesthesiology. Students will experience various aspects of perioperative and subspecialty care that will inform their decision for residency training. Students will be given an opportunity to rank-order subspecialties: acute pain service, obstetrical anesthesia, and pediatric anesthesia. Assignment to specific teaching hospitals will be arranged by the course coordinator. Students will be assigned for 2 or 3 weeks of perioperative anesthesia (OR, POCU, PACU) and 1 or 2 weeks of subspecialties. Students may choose to work a few afternoon and evening shifts in order to experience call-like schedules and cases, but neither in nor beeper call are required. Additionally, students may be presented with the opportunity to participate in simulation sessions with residents and faculty at Fairbanks Simulation Center. Clinical experience will be complemented by clinical teaching, didactic sessions, and departmental conferences. Independent and self -directed learning will be required through Canvas modules, assigned reading, PBLI, and reflective writing.

The primary focus of this ACE is to achieve a foundational level of understanding for the practice of anesthesiology as a specialty through involvement in the continuous care of patients from POCU, OR, and PACU until discharge, and at least one subspecialty area. Additionally, students will interact with residents to gain insight into anesthesiology training program expectations and ACGME requirements. It is important to note that this ACE course is designed to emphasize critical thinking, deductive reasoning, clinical decision making, and problem-based learning. Active learning will include cognitive, affective, communication, and interpersonal skill development. As such, there is not a case log requirement for this course, and students should not anticipate developing procedural skills.


Elective Details:

Primary Contact for Add/Drops: Belinda Sanborn (bmsanbor@iu.edu)

Director: Gulraj Chawla, M.D.

Campus: Indianapolis

Location: University, Methodist, Eskenazi, Riley Hospitals


Learning Objectives

  • Adult anesthesia (OR)
    1. Perform preanesthesia evaluation (PC1)
    2. Assign and justify ASA Physical Status Classification (PC2)
    3. Integrate data from a clinical encounter to develop a patient-centered plan of care (PC3)
    4. Provide justifications for interventions and management of a patient's diseases, injuries, and functional deficits of organ systems (MK4)
    5. Perform airway evaluation, including recognition of potentially difficult airway (PC1)
    6. Demonstrate knowledge in anatomy, physiology, pathology, and pharmacology (MK2)
    7. Demonstrate the ability to make appropriate diagnostic and therapeutic decisions based on limited information (MK4)
    8. Demonstrate ability to remain vigilant to task during long periods of stable maintenance of anesthesia and then calm, rational, efficient, and effective at times of patient instability and crisis (P2)
    9. Demonstrate appropriate transfer of care between providers or settings (PC6)
    10. Manage postoperative care through appropriate selection of postoperative orders (PC3)
    11. Manage postoperative complications such as acute pain, nausea/vomiting, hemodynamic instability, and respiratory distress (PC5)
    12. Participate in postoperative visits to assess success of the anesthetic management and patient satisfaction (ISC2)
    13. Investigate, through daily reading, various topics including airway, fluid resuscitation, autonomic nervous system, and cardiovascular physiology (PBLI1)
    14. Understand the surgical department environment and management and need for efficiency while maintaining patient safety as a primary responsibility (SBP4)

    Acute pain service (APS)

    1. Describe the pathophysiology of acute and chronic pain (MK3)
    2. Describe management of acute postoperative pain (MK4)
    3. Identify anatomical structures on ultrasound images (MK1)
    4. Formulate a treatment plan for acute pain management after evaluation and assessment of patients (PC3)
    5. Participation in the management of acute pain with regional anesthesia techniques, including selection of peripheral nerve block or neuraxial technique and utilization of ultrasound (PC5)

    Obstetric anesthesia (OB)

    1. Discuss the physiologic changes associated with pregnancy (MK2) and apply this knowledge to the anesthetic management of obstetric patients (PC1)
    2. Perform preanesthesia evaluation (PC1)
    3. Assign and justify ASA Physical Status Classification (PC2)
    4. Integrate data from a clinical encounter to develop a patient-centered plan of care (PC3)
    5. Discuss the anatomic considerations of endotracheal intubation and airway management for a parturient (MK1)
    6. Discuss basic fluid management and hemodynamic changes (PC5)
    7. Participate in postoperative visits to assess success of the anesthetic management and patient satisfaction (ISC2)
    8. Understand the labor and delivery department environment and management and need for efficiency while maintaining patient safety as a primary responsibility (SBP4)

    Pediatric anesthesia (PEDS)

    1. Evaluate a pediatric patient as to the indications and contraindications for anesthetic management (PC1)
    2. Discuss the anatomic considerations of endotracheal intubation and airway management for a pediatric patient (MK1)
    3. Discuss basic fluid management (PC5)
    4. Discuss the basic monitoring for all anesthetized patients as well as the indications for more invasive monitoring (MK4)
    5. Describe the anesthetic management for an infant (PC5)
    6. Discuss risk factors for and management of postoperative nausea and vomiting (MK4)
    7. Discuss recommendations for the management of postoperative pain in a pediatric patient (MK4)
    8. Describe indications and contraindications for common regional approaches for postoperative pain management (SBP2)
    9. Understand assessment and management of the psychological aspects of child for surgery (MK4)

Assessment

  • Clinical Performance Evaluation

Enrollment Information

Prerequisites: 4th year status; Completion of 3rd year Anesthesia Clerkship

Availability with Max Students per Month:

AprMayJuneJulyAugSeptOctNovDecJanFebMar
121212810101022000

Duty Hours: 45

Time Distribution: 70% Clinical; 5% Lecture/Seminar; 20% Library/Research; 5% Online

Elective Type Category: AC- Advanced Clinical

Notes and Enrollment Information:

Add/Drop Contact Person: Belinda Sanborn (bmsanbor@iu.edu) Students must contact Belinda Sanborn at bmsanbor@iu.edu for enrollment.

Third Year Elective? No


Interprofessional Skills and Service Learning

Interprofessional Collaborative Skills: Yes

Skills Description:

Service Learning Included: None