Anesth Analg 2008; 106:1587-1588
© 2008 International Anesthesia Research Society
doi: 10.1213/ane.0b013e31816a3164
LETTER TO THE EDITOR
Section Editor:
Lawrence Saidman
Education in Anesthesiology Should Be Evidenced-Based
Randall M. Schell, MD,
Edwin A. Bowe, MD, and
Regina Y. Fragneto, MD
Department of Anesthesiology; University of Kentucky; Lexington, Kentucky; rschell{at}uky.edu
To the Editor:
In the 45th Rovenstine lecture,1 Reves states "In research we have done too little, for too long, but it is not too late." We include the paucity of research related to medical education in this same category and propose that current and appropriate efforts to encourage the practice of evidence-based medicine should be expanded to include evidence-based medical education.
The Institute of Medicine's (IOM) report entitled "Health Professions Education: A Bridge to Quality" notes "there have been few rigorous long-term evaluations of any aspect of health professions education ... It is difficult to locate even a single evaluation that measures changes in patient outcomes or satisfaction as a result of any revision of curriculum."2 The ACGME Outcome Project3 is an example of a regulatory body imposing significant and thoughtfully developed but nonevidence-based changes in graduate medical education including the requirement for developing competency-based teaching and evaluation. However, the 2003 IOM report appropriately notes that there is "disagreement about what constitutes evidence of competency, how often it should be demonstrated, and who should judge."
In educational research, there is a need for large multiinstitutional studies and evaluation of more meaningful and clinically relevant outcomes. The IOM report on Academic Health Centers recommended that Congress create a dedicated fund to foster innovation in the methods and approaches used to prepare health professionals.4 An evidentiary link between education research funding and study quality has recently been demonstrated.5 However, where will we find a source of funding and who will lead in our specialty?
Since 1986, the Foundation for Anesthesia Education and Research (FAER) has been a nonprofit charitable and educational organization partially funded by the American Society of Anesthesiologists that fulfills a mission to promote the generation of new knowledge in anesthesiology. Since inception, research in education grants have comprised <5% of all grants provided. We propose that FAER consider supporting a program assisting academic anesthesiologists in obtaining training in educational research. For example, $20,000 from FAER and matching funds from their academic department would support graduate level training in programs such as the Master of Academic Medicine Program at the University of Southern California, which includes courses in designing, implementing, and studying innovation in academic medicine.
Imagine if anesthesiology not only practiced evidence-based medicine but also was the first specialty to teach and train residents utilizing evidence-based education.
REFERENCES
- Reves JG. We are what we make: transforming research in anesthesiology. The 45th Rovenstine Lecture. Anesthesiology 2007;106:826–35[Web of Science][Medline]
- Institute of Medicine. Health professions education: a bridge to quality. Washington, DC: National Academies Press; 2003
- Available at: www.acgme.org/
- Institute of Medicine. Academic health centers: leading change in the 21st century. Washington, DC: National Academies Press; 2003
- Reed DA, Cook DA, Beckman TJ, et al. Association between funding and quality of published medical education research. JAMA 2007;298:1002–9[Abstract/Free Full Text]
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