Medical education: Overview

Abstract
Introduction: Although uncommon, local anaesthetic systemic toxicity (LAST) may impose fatal risk to the patients. We investigated the awareness of LAST and knowledge on local anaesthetics among our postgraduate trainees.

Materials and methods: A total of 134 postgraduate trainees from the departments of general surgery (Surgical), orthopaedic surgery (Ortho), otorhinolaryngology (ENT), obstetrics and gynaecology (OBGYN), as well as anaesthesiology and intensive care (Anaesth) were recruited. A validated questionnaire was used to assess awareness and knowledge. All participants attended a medical-education session and completed the questionnaire as preassessment and postassessment. Data were analysed, and comparisons between disciplines were conducted.

Results: The trainees' awareness of LAST was overall poor at preassessment which improved almost 6-folds at postassessment. Surprisingly, only 20 (45.5%) participants from the anaesthesiology group had awareness of LAST at preassessment, and none of the participants were from surgical, orthopaedic, and obstetrics and gynaecology departments. Preassessment scores were significantly higher in the anaesth group as compared to all other groups; with a difference in the average score for Anaesth vs Surgical of 3.46 (95%, CI:2.17, 4.74), Anaesth vs Ortho of 3.64 (95%, CI:2.64, 4.64), Anaesth vs ENT of 3.43 (95%, CI:2.20, 4.67), and Anaesth vs OBGYN of 6.93 (95%, CI:5.64, 8.21). However, there was no significant difference of awareness scores between all participants at postassessment scores.

Conclusion: The overall level of awareness was poor. However, the implementation of an education session significantly improved the knowledge and awareness across all disciplines.

Abstract: E-learning is increasingly used in postgraduate medical education. Its numerous benefits include an enhanced learning experience through learning style individualisation, interactive elements, and assessment through tests and quizzes. Current meta-analyses conclude that the overall effectiveness of e-learning is comparable to traditional teaching modalities. However, studies demonstrating its benefits are heterogeneous and of varying quality. This randomised controlled trial aims to investigate whether contemporary e-learning completed prior to a course in obstetric anaesthesia prepares the course participants better than self-study of written course material.

Abstract
The importance of resident physicians as clinical educators is widely acknowledged in many clinical specialties and by national accreditation organizations for medical education. Within anesthesiology training programs, there is growing attention to the role of trainees as clinical educators. This narrative review describes the theoretical and demonstrated benefits of clinical teaching by residents in anesthesiology and other medical fields, summarizes current efforts to support and promote residents as educators, and suggests ways in which anesthesiology training programs can further assess and develop the role of residents as clinical educators.

Abstract
Background: Anaesthesiologists and intensive care doctors have become progressively more mobile across Europe. The standardisation of training systems has been recommended by the European Union of Medical Specialist (UEMS) to facilitate the mutual recognition of professionals.

Objective: We aimed to assess the level of compliance with the 2018 European training requirements (ETR) for the specialty of anaesthesiology, pain and intensive care medicine.

Methods: An electronic questionnaire on the duration of the training and assessment methods in anaesthesiology and intensive care medicine was circulated via e-mail to the National Anaesthesia Societies Committee (NASC) representatives of all 41 European countries as defined by the WHO.

Results: All 41 countries replied. The average duration of training was 4.7 years; in 29% of the countries, it was less than 5 years. In 78% of the countries, a mandatory written examination was required, and the most common form was a national test (44%), with only 27% using the European Diploma of Anaesthesia and Intensive Care. In the subgroup of the 26 EU countries investigated, the average duration of the training was 5 years and in 19% was less than 5 years. In the subgroup of the 15 non-EU countries, the average duration of training was 4.25 years, with 46% of the countries having a duration shorter than 5 years.

Conclusions: This survey highlighted the diversity in the training in anaesthesiology and intensive care medicine in Europe despite the recommendations advocated by the EBA-UEMS. The findings on the duration of training demonstrated that the target of 5 years has not been universally achieved yet with a substantial difference between EU and non-EU countries. The evidence presented suggests the need for initiatives dedicated to implement compliance with the advocated duration and competence requirements reported in the European Training Requirement for anaesthesiology and intensive care by UEMS.