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July 1999
Volume 63 |
Number 7
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| Problem-Based
Learning Discussion Program for 1999 |
Denham S. Ward, M.D.,
Ph.D., Chair
Committee on Problem-Based Learning Discussions
This year's ASA Annual Meeting will have a record number of Problem-Based
Learning Discussion (PBLD) sessions, which is a reflection of
the utility and the maturity of this learning tool. Many medical
schools, including my own, are moving to a curriculum that is
centered on problem-based learning. This curriculum motivates
students to learn medicine in the way that they will be applying
it - to clinical problems. That is not to say that basic science
is no longer important. Quite the contrary, with basic science
knowledge rapidly expanding and the time from discovery to clinical
application shortening, there is a growing need for students at
all stages of their careers to be able to combine basic science
with clinical applications. A key element of the problem-based
learning environment is the practice of evidence-based medicine.
When a clinician is faced with a problem, the ability to search
the literature easily and electronically for relevant information
is changing how medical care is provided. These tools organize
the relevant medical evidence that forms the basis of current
treatment; however, it is still necessary to analyze this literature
and apply the evidence to the particular clinical problem.
The key elements of evidence-based medicine are: 1) the definition
of the particular clinical problem; 2) an electronic literature
search to find the best relevant studies; and 3) analysis of the
data to formulate the optimal treatment plan. The problem-based
learning discussions at the ASA Annual Meeting provide a forum
for practicing anesthesiologists to apply these elements to defined
clinical problems. To get the most out of the PBLD session, the
learner needs to prepare. These are not sessions where opinions
fly unchallenged or the word of the facilitator is taken as the
only way. To get the most out of these sessions, participants
should do their own literature search and analyze the evidence
to formulate a plan. The model discussion provided by the facilitator
should serve as a starting point for a lively, evidenced-based
discussion.
Again this year, many experts are facilitating sessions covering
a wide variety of sessions. The PBLD sessions are an exceptional
educational value, allowing the participant to work with the facilitator
in a small-group session. We will have popular facilitators returning
with new or updated cases plus many new facilitators are joining
the program. The facilitators include Philip Boysen, M.D., David
H. Chestnut, M.D., Saundra E. Curry, M.D., Ronald J. Faust, M.D.,
Elizabeth Frost, M.D., Simon Gelman, M.D., George A. Gregory,
M.D., Jeffrey B. Gross, M.D., Brett B. Gutsche, M.D., Carol A.
Hirshman, M.D., Ronald L. Katz, M.D., Dennis F. Landers, M.D.,
Philip Liu, M.D., Vinod Malhotra, M.D., Mervyn Maze, M.D., Donald
S. Prough, M.D., Michael Roizen, M.D., and Theodore H. Stanley,
M.D.
With 142 sessions scheduled and some of the more popular PBLDs
presented more than once, there is a PBLD and a time that should
fit everyone's ASA schedule. The topics include common clinical
problems such as airway foreign bodies, a child with a URI, TURP
and hip fractures in the elderly. There are also discussions of
more uncommon clinical problems such as emergency AAA surgery
in a patient with thyrotoxicosis, a patient with malignant hypothermia,
congenital diaphragmatic hernia, awareness under anesthesia and
bronchogenic carcinoid.
Anesthesia subspecialties of pain and intensive care unit care
are not ignored. There are discussions on the burn patient and
the multiple trauma patient as well as the patient with back or
leg pain. There are also cases that deal with management and administration
(dealing with a 5 percent budget cut and preserving the academic
mission), ethics (abortion in a minor, DNR and drug addiction
in a colleague) and education (anesthesia in the generalist curriculum
and the problem resident). Discussions involving leading edge
science such as alpha-2 agonists, nitric oxide and new treatments
for sepsis are also included.
This year, the PBLD sessions will be held in the Hyatt Regency
Hotel. There will be breakfast sessions on Saturday and Sunday,
October 9-10, from 7:30 a.m. to 8:45 a.m. and luncheon sessions
on Saturday through Tuesday, October 9-12, from 12:30 p.m. to
1:45 p.m. Also on Monday and Tuesday, there will be refreshment
sessions from 3:45 p.m. to 5 p.m. The specific room assignments
will be given on the PBLD tickets. The ASA Annual Meeting registration
booklet, sent to all ASA members in June, includes a brief description
of each PBLD case to aid in selecting the ones of most interest
to you.
The tickets will be $30 for the breakfast sessions, $50 for
the luncheon sessions and $20 for the refreshment sessions. This
includes the food service and the PBLD book (also available separately
for $15). The sessions are filled on a first-come first-served
basis, and almost all the sessions sell out with the popular ones
filling very quickly. So register early, list alternative choices
and get ready to start work on an interesting clinical problem.
This PBLD program continues the tradition, and I am looking
forward to seeing you in Dallas!
Denham S. Ward, M.D., Ph.D., is Professor
and Chair, Department of Anesthesiology, University of Rochester
Medical Center, Rochester, New York.
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