Obstetric (OB) Anesthesia (CA-1 and CA

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GOALS & OBJECTIVES
Advanced Obstetrical Anesthesiology Rotation
Rotation Director:
Learners:
Robert Hansen, MD
CA-3 Residents
Goals:
This rotation in advanced obstetrical anesthesiology provides the resident with increased
responsibilities and learning opportunities in comparison to initial obstetrical
anesthesiology rotations. The resident, through exposure to higher risk parturients, will
acquire an enhanced ability to provide obstetrical anesthetic care. Through the initial
rotation, the resident will have acquired basic skills of regional and general anesthetic
management and technique; these skills will be enhanced through participation in more
complex cases. Likewise, the didactic component will emphasize more advanced
concepts of provision of obstetrical anesthetic care.
Objectives:
During this rotation, the resident will progress toward attainment of the following core
competencies:
PATIENT CARE

Perform preanesthetic history and physical examination and laboratory data
evaluation in an increasingly independent manner

With increasing independence, formulate an obstetrical anesthetic plan

Effectively interact with patients, their families and significant others in a manner
which demonstrates compassion, respect and integrity

Demonstrate the ability to modify anesthetic plans to meet changing, urgent or
emergency considerations

Technically perform obstetrical anesthetic mandates with competence and
increasing independence

Assume an increasingly responsible role as a member of the health care team
providing care to the obstetrical patient

Independently devise safe and effective plans for treatment of post-partum pain
Goals and Objectives of the
Advanced Obstetrical Anesthesiology Rotation
MEDICAL KNOWLEDGE

Demonstrate an understanding of pathophysiologic considerations of the high risk
parturient

Demonstrate an understanding of evaluation and management of the parturient
presenting for both elective and emergency care having concurrent airway
challenges

Demonstrate an understanding of the pharmacologic management of the high-risk
obstetrical patient

Demonstrate an appreciation for the indications, contraindications and potential
complications of varying anesthetic techniques used to manage high-risk
parturients

Demonstrate an advanced familiarity with scientific literature pertaining to the
care of the obstetrical anesthetic patient

Demonstrate an advanced familiarity with tenets of maternal and fetal physiology
and demonstrate an advanced understanding of how these impact analgesic and
anesthetic care

Demonstrate an understanding of principles and rationale of fetal assessment
including stress and non-stress tests, and fetal monitoring

Demonstrate an understanding of neonatal resuscitation

Demonstrate an advanced understanding of the management of peripartum
hemorrhage
PROFESSIONALISM

The resident will demonstrate commitment to the precepts of ethics and to the
individualized requirement for care of their obstetrical patients.

Residents will be proficient and respectful when interacting with patients, family
members, significant others and all members of the healthcare team.

The resident will develop an understanding of the importance of principles of
ethics, requirements of confidentiality, and informed consent.

The resident will demonstrate an appreciation of business practices of obstetrical
anesthesia.
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Goals and Objectives of the
Advanced Obstetrical Anesthesiology Rotation

Residents will learn to develop leadership skills that will enable them to assume
responsibilities necessary for integration of anesthetic care with the totality of
care required for the parturient.
PRACTICE-BASED LEARNING AND IMPROVEMENT

Residents will be better enabled to evaluate published literature in specialty
journals and textbooks as applicable to the practice of obstetrical anesthesia. They
will also understand the importance of adherence to basic ethical principles.

Through presentation to the faculty, medical and other healthcare students and
members of the extended care team, the resident will learn to facilitate the
learning and improvement in practice of others.

Residents will learn to evaluate their own performance in caring for the parturient
and thereby enhance their own therapeutic capabilities in obstetrical anesthetic
care.
INTERPERSONAL AND COMMUNICATIONS SKILLS


Residents will learn the techniques and skills needed for effective communication
with obstetrical patients and their families.
Residents will show commitment to their patients by demonstrating a
professional, ethical and responsible demeanor while interacting with colleagues
and other health care professionals.

Residents will demonstrate their communication skills through daily interaction
with the varying members of the health care team.

The residents will learn to work as an effective member of the healthcare team.

Residents present their cases to the faculty and other medical will evidence of
advanced understanding of obstetrical anesthetic concerns for both routine and
complex cases.
SYSTEMS-BASED PRACTICE

Residents will develop an increased understanding of the necessity of costeffective obstetrical anesthetic health care. They will become conversant with
issues pertaining to resource allocation.

Residents will develop an understanding of how the high risk parturient traverses
the health care system and how decisions made in the conduct of their care
impacts the patient and the health care system as a whole.
-3-
Goals and Objectives of the
Advanced Obstetrical Anesthesiology Rotation

Residents will develop an understanding of how the various components of the
health care system utilized in care of the high risk parturient interact.

Residents will develop behaviors that show an appreciation for the impact of their
practices on overall delivery of care to the obstetrical anesthetic population with
an emphasis on the high risk parturient.
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 standardized evaluation
form includes the six essential components of the core competencies: patient care,
medical knowledge, professionalism, interpersonal and communication skills, practicebased 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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