The UC Irvine Health Department of Anesthesiology & Perioperative Care provides residents an innovative and comprehensive educational curriculum called “4U”. Each “U”, or “University”, represents one of the four years of anesthesiology training so that residents progress from acquiring the fundamental knowledge needed to be a perioperative physician beginning in the clinical base year to preparing for independent practice in the senior year.
Each resident class is provided a protected education day every four week period. These “4U Days” are tailored to each specific resident class and include a variety of activities including case conferences, simulation and interactive didactics. Session topics are guided by The American Board of Anesthesiology (ABA) and American Society of Anesthesiologists (ASA) content outline and new Anesthesiology Milestones. In addition, 4U sessions are recorded on Panopto, an online library for presentations, and made available for residents to review at their convenience.
The 4U day was a great education session. I learned a great deal and was engaged throughout because of the variety of presentation formats throughout the day. It motivated me to study more even after the session was over.
- CA-2 Resident
Clinical base year (CBY) residents have education days from 1 to 5 p.m. every fourth Thursday. Areas of focus include anatomy, monitors, equipment, physiology, pharmacology, and pathophysiology of disease states as it relates to anesthesia. Reading assignments are from Basics of Anesthesia by Stoelting, and correspond to session topics. Case discussions that integrate basic knowledge into clinical context aim to make learning engaging and interactive. Incorporating a structured learning program in the clinical base year also gives CBY residents an opportunity to bond with fellow residents and faculty early on during their training. All CBY residents rotate as a class onto anesthesiology for their last intern month for “Anesthesia Boot Camp”. This four week rotation provides a smooth transition to clinical anesthesia by emphasizing the basics of anesthesia, patient safety, and system-based practice.
4U for clinical anesthesia residents (CA-1, CA-2, CA-3) occurs from 8 to 5 p.m. on the second through fourth Wednesday of each block, alternating between each resident class. Each session is devoted to a major theme and tailored to the specific class level. Online pretests are administered prior to each session and cover preassigned readings from Clinical Anesthesia by Barash. These tests provide self-assessment in preparation for each session. A focused review of commonly missed questions during each session provides opportunity to ask faculty questions and helps to fill knowledge gaps.
Lectures, problem-based learning discussions, and resident led ABA keyword reviews are a regular part of each session in order to help residents prepare for the ABA’s new staged examination system. While CA-1 sessions focus on basic anesthesia, CA-2 and CA-3 sessions cover advanced topics with an emphasis on clinical subspecialties. Whenever possible, these sessions are led by faculty with particular interest or subspecialty expertise. Faculty also provide relevant journal articles for discussion based on session topics. A senior ABA Board Examiner conducts regular “oral exams” during the CA-2 and CA-3 4U sessions.
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Workshops and simulation play important roles in resident education at UC Irvine Health and have been fully integrated into the 4U Day. CBY residents participate in hands-on workshops for arterial and central line placement as well as basic airway management. Workshops for CA-1 residents include advanced adult and pediatric airway management. An annual regional anesthesia workshop, which includes review of neuraxial blocks and ultrasound-guided nerve blocks, and the cardiovascular workshop, focusing on TEE simulation, CV monitors and cardiac diseases are incorporated into the CA-3 year. In addition, all residents participate in high-fidelity simulations at the state-of-the-art simulation center, led by faculty with expert training, followed by case debriefing. In addition, a novel perioperative ultrasound course is incorporated into the clinical anesthesia years.
Anonymous online session feedback from residents and faculty instructors are regularly reviewed by the Curriculum Committee to ensure quality of didactic sessions.
All anesthesia residents are expected to take the American Board of Anesthesiology/American Society of Anesthesiology In-Training Exam (ABA/ASA ITE) each spring. In addition, clinical anesthesia residents are expected to take the Anesthesia Knowledge Test (AKT) at one, six, and 24 months of training.
Faculty administer additional mock oral board exams twice a year to individual clinical anesthesia residents. Each resident is also assigned a faculty mentor to provide guidance throughout residency.
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