GOALS AND OBJECTIVES
TU - Pre-Operative Anesthesia Rotation
Rotation Director:
Learners:
Lorena Dumas-Guntner, MD
CA-1 Residents
Goals:
Upon completion of this rotation, the resident will possess the skills and knowledge to:

Perform an accurate pre-operative assessment of patients scheduled for a variety
of surgeries and procedures. The resident will gain an understanding of the
potential impact of co-morbidities including, but not limited to, those referable to
pulmonary, cardiovascular, renal, hepatic, endocrinologic, body habitus and
cancer considerations.

Provide consultation to those requiring assistance with patients being prepared for
anesthesia and surgery.

Perform an assessment of the airway and identification of various potential issues
that may manifest as problems during the perioperative period.

Function as a member of the team preparing a patient for anesthesia and surgery.
Objectives:
PATIENT CARE

Residents will develop an understanding of requirements for preparation of a
patient for the perioperative experience. This will include development of an
understanding of appropriate techniques of information acquisition and
counseling.

Residents will develop an understanding of risk assessment, requirement for
preoperative sedation and for the continuation or cessation of various
pharmaceuticals.

Residents will gain experience with techniques required to deal with the
psychological discomfort of patients, their family members and significant others
associated with concerns about the perioperative experience and especially those
referable to anesthesia per se.
Goals and Objectives of the
Pre-Operative Anesthesia Rotation

Residents will gain an appreciation of potential ethnic, cultural, age and gender
concerns of patients contemplating anesthesia and surgery.

Residents will gain familiarity with techniques used to explain the varying
components of anesthetic care to patients in a manner that promotes not only a
better appreciation of the anesthetic process but also in a manner that
communicates an atmosphere conducive to fostering confidence and
professionalism.

Residents will learn how the preoperative assessment process functions to
promote patient care and safety.
MEDICAL KNOWLEDGE

Residents will acquire knowledge of the principles of proper selection of
preanesthesic medications in order to facilitate anxiolysis, sedation, amnesia and
analgesia.

Residents will develop an understanding of the pharmacology of varying
preoperative agents including, but not limited to, opioids, sedatives, anxiolytics,
anti-emetics, antacids and anticholinergics.

Residents will develop an understanding of the risks and benefits of varying
anesthetic plans for individuals undergoing anesthesia for diverse surgeries or
procedures. They will also develop an understanding of the need for provision of
alternative strategies to meet the needs of changing circumstance.

Residents will develop skills necessary to obtain an appropriate history and to
perform an appropriate physical examination in order to effectively evaluate
patients scheduled for anesthesia and surgery.

Residents will gain an understanding of the informed consent process.

Residents will develop an understanding of preoperative testing requirements and
the desirability of optimization of patient conditions, if possible, prior to
contemplated elective surgeries.
PRACTICE-BASED LEARNING AND IMPROVEMENT

Residents will develop an appreciation of the desirability of ongoing evaluation of
their performance in order to enhance and promote their professional maturation.

Through application of constructive criticism from varying sources, the resident
will be enabled to achieve improvements in their practices of preoperative
evaluation and preparation of patients scheduled for surgery and diverse elective
procedures.
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Goals and Objectives of the
Pre-Operative Anesthesia Rotation

Residents will demonstrate their commitment to improvement of their capabilities
by attendance at applicable conferences and meetings and by active participation
in educational activities.
INTERPERSONAL AND COMMUNICATIONS SKILLS

Residents will develop skills in effective communication through interaction with
patients, families and significant others. They will also refine their
communication skills through daily interaction with varying members of the
health care team.

Residents will learn the importance of compassionate, responsible and appropriate
avenues of communication with patients and others concerned for their welfare.

Residents will demonstrate commitment to attainment of the active listening skills
required to effectively interact with patients, families and significant others, and
members of the extended health care team.

Residents will develop skills necessary to be responsive to questions and
concerns. They will develop skills necessary to appropriately respond to requests
for assistance.
PROFESSIONALISM

Residents will achieve an understanding of the importance of conducting
themselves in a manner such that fosters the communication of confidence and
professionalism to patients, their families and significant others, and other
members of the health care team.

Residents will perform preoperative assessments in compliance with departmental
requirements.

Residents will demonstrate sensitivity to patient needs and concerns.

Residents will demonstrate commitment to ethical principles pertaining to
confidentiality of patient information and to the obtainment of informed consent.
SYSTEMS-BASED PRACTICE

Residents will develop an understanding of the ramifications on the health care
system of the decisions that are made during the preoperative assessment period
and how these decisions affect the allocation of resources.
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Goals and Objectives of the
Pre-Operative Anesthesia Rotation

Residents will develop an understanding of how patients presenting for
preoperative anesthetic evaluation flow through the health care system.

Residents will learn, through involvement with quality improvement program
initiatives, how care may be improved for individual patients and, at the same
time, how efficiencies may be achieved for the health delivery system.

Residents will develop the skills required to enable effective function in an
interdisciplinary environment.
The acquisition of the above-elaborated core competencies will be facilitated by clinical
assignments made by the attending faculty. As a result of these ongoing rotations, the
resident will progressively demonstrate an incremental understanding of the principles of
anesthesiology and demonstrate increasing competencies in performance of the technical
requirements of patient care. As the resident progresses, an appropriate understanding of
self-limitations will be a component of development of the requisite judgment required of
a consultant in anesthesiology. The resident will be expected to complete reading
assignments and other academic endeavors as mandated by the faculty. Independent
study in addition to required readings is both desirable and recommended. The
evaluative process for this rotation will be undertaken in concert with departmental
evaluative policies. Residents will receive evaluations from faculty with whom they have
worked and these evaluations include all core competencies. The evaluations are
reviewed by the rotation director with the resident. The evaluations are signed by the
resident and made available to the Clinical Competency Committee. The faculty is also
encouraged to give residents ongoing verbal feedback about their performance of the core
competencies on a daily or as needed basis. The departmental eletronic evaluation form
includes the six essential components of the core competencies: patient care, medical
knowledge, professionalism, interpersonal and communication skills, practice-based
learning and improvement, and systems-based practice. The resident will evaluate the
rotation as a component of the formal evaluative program process and will be encouraged
to supply ongoing feedback on the rotation to the faculty and staff. They will likewise
evaluate the faculty as part of the formal evaluative process of the teaching program.
P. Primeaux
2009
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