Clinical experience of neuroanaesthesia trainees: A survey

INTRODUCTION

The neuroanaesthesia syllabus for intermediate and higher modules involves exposure to a wide variety of clinical experiences from elective and emergency intracranial procedures, spinal surgery, interventional radiology and anaesthesia for imaging such as magnetic resonance imaging (MRI).

Some centres have designed a minimum clinical caseload for trainees (such as a minimum number of craniotomies), whereas others have no such targets.

Monitoring this experience is important to assess all neurosurgical sub-specialties that are adequately covered.

Aims

The aims of this audit were to assess adequacy of clinical exposure of neuroanaesthesia trainees in the North West deanery who were undergoing their intermediate and higher modules over a period of 1 year. These were compared to the syllabus for the relevant module to ensure that these areas were adequately being covered.

Syllabus criteria

Trainees undertake their first neuroanaesthesia module during their intermediate stage of training: A 2-year period of experience which follows basic training and passing the Primary Fellowship of the Royal College of Anaesthetists (FRCA). Neuroanaesthesia is then revisited for a higher module, following passing the final FRCA, during the next level of training.

The Royal College of Anaesthetists (RCoA) 2010 syllabus for neurosurgery, neuroradiology and critical care includes knowledge areas and skill areas for attainment.[1]

The areas of learning that should be assessable are as follows.

Intermediate experience should include:

• Elective and emergency intracranial surgery

• Shunt surgery

• Cervical spinal surgery

• Lumbar spinal surgery

• Prone and lateral positioning

• Neuroradiology

• Simple emergencies (e.g., external ventricular drain) with distant supervision.

Higher module trainees should take part in:

• Routine and emergency surgery

• Perioperative care for complex spinal surgery

• Leadership of neuroanaesthesia emergencies

• Complex intracranial and spinal surgery

• Neuroradiological investigations

• Indirect supervision of emergency non-complex intracranial/spinal surgery.

Standards

Trainees should meet the requirements of the RCoA syllabus for their modules.

Therefore,

• 100% of intermediate trainees should have experience in the above areas and have performed simple emergency cases with distant supervision

• 100% of higher trainees should have experience in the above areas and have experience with distant supervision in non-complex intracranial and spinal surgery.

• REFERENCES

• 1 Royal College of Anaesthetists 2010. Curriculum for a CCT in Anaesthetics. 2010 Available from: http://www.rcoa.ac.uk/careers-training/training-anaesthesia/the-training-curriculum/CCT2010 [Last accessed on 2015 Jan 15].
• 2 Lonergan PE, Mulsow J, Tanner WA, Traynor O, Tierney S. Analysing the operative experience of basic surgical trainees in Ireland using a web-based logbook. BMC Med Educ 2011; 11: 70
• 3 Beasley SW, McBride C, Pearson ML. Use of the operative logbook to monitor trainee progress, and evaluate operative supervision provided by accredited training posts. Surgeon 2011; 9 Suppl (Suppl. 01) S14-5