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July 2003
Volume 67
Number 7



ASA Workshop on New and Old Challenges in Clinical Anesthesia: The ‘PRACTISS© Approach

Armin Schubert, M.D.
John E. Tetzlaff, M.D.


On November 1–2, 2003, the annual ASA Regional Workshop will be given at the Cleveland Clinic Conference Center in Cleveland, Ohio, which opened this spring.

ASA’s workshop “New and Old Challenges in Clinical Anesthesia” is one product of the forward-thinking ASA Committee on Outreach Education. It is offered in response to an often-voiced call for more clinically relevant continuing medical education (CME) for anesthesiologists. The small-group format, the ability to choose a number of “case” tracks and the multitude of interactive learning opportunities are certain to set this workshop apart from traditional CME.

An Exciting New Venue
From its 300 elegantly appointed guestrooms, including 23 luxurious suites, to its state-of-the-art MBNA Conference Center, magnificent Founders’ Ballroom and fine dining facilities, the new InterContinental Hotel and Conference Center is the ultimate in sophistication and luxury. Conference attendees will have easy access to the beautiful University Circle area with its many museums and Severance Hall, home of the world-renowned Cleveland Philharmonic Orchestra, and to many other attractions in downtown Cleveland.

The Practiss© Approach

The Committee on Outreach Education, under the leadership of Peter Rock, M.D., and previously, Joanne M. Conroy, M.D., has charted a course toward highly interactive educational offerings that harness the opportunities offered by new electronic media. Course co-directors Armin Schubert, M.D., and John E. Tetzlaff, M.D., are taking their cue from a powerful trend that continues at ASA Annual Meetings: Attendees have flocked to interactive educational offerings such as Problem-Based Learning Discussions (PBLDs) and hands-on workshops while the popularity of traditional lecture settings has decreased.

The November course is meant for a general audience of anesthesia practitioners and offers small group, interactive tutorials about common cases with challenging issues, which the course directors call Practiss© (Practice-Relevant Anesthesia Case Themes in Interactive Small Sessions). Under the motto “Practiss© makes perfect,” the directors have put together a stimulating, highly interactive case-based learning format relevant to issues encountered in everyday practice.

Topics Highly Relevant to General Practice
Examples of the case themes to be presented appear in Table 1. Case material is selected according to the following criteria:

  • Not infrequently seen in general practice

  • Has important management implications for clinical practice

  • May involve a serious disease but no “zebras”

  • Highlights newer surgical procedures

  • Calls attention to changing practice patterns and comorbid conditions.


These Practiss© case discussions promise to center on challenging patients with interesting yet commonly encountered pediatric, obstetric, cardiac and neurological issues. Participants can choose between a number of tracks, each occurring in state-of-the-art, small-session classrooms and each containing six rich case experiences; some opportunities to switch tracks will likely be available.

Teaching Materials/Syllabus Include Participant Input
Participants can expect to receive a brief case description shortly after registering for the course (online registration on the ASA Web site will be available the first week of July). Upon arrival at the conference hotel, participants will receive a more detailed case and discussion guide, including suggested questions. Each case can be expected to have one or two clinical decision quandaries. At the outset of the conference, participants will gather in plenary session, then move to their 90-minute small-group sessions for in-depth case discussion. The session facilitators will make sure there is ample time for discussion and contributions to case management by the participants.

Facilitators also will demonstrate how to bring electronic teaching materials into the classroom during discussion. At the end of each session, a short presentation will summarize the important points in the case, including, when possible, a brief review of relevant evidence-based medicine and a summary of the material contributed by the session participants. After the conference, participants will receive a syllabus consisting of a model case discussion, a summary of relevant, evidence-based medicine findings and a summary of the contributions from session participants, all distilled into clear clinical recommendations.

For more information, please contact Armin Schubert, M.D., The Cleveland Clinic Foundation, 9500 Euclid Ave., Desk E31, Cleveland, OH 44195, telephone: (216) 444-3754 fax: (216) 444-9628, e-mail: <schubea@ccf.org>; or John E. Tetzlaff, M.D., The Cleveland Clinic Foundation, 9500 Euclid Ave, Desk E31, Cleveland, OH 44195; telephone (216) 444-3739; fax: (216) 444-9812; e-mail <Tetzlajs@ccf.org>.

Table 1: Practice-Relevant Anesthesia Case Themes in Interactive Small Sessions (Practiss©)

• “Former” premie and outpatient herniorrhaphy • Dental restorative procedure and Down’s syndrome • Rheumatoid arthritis and anterior spinal fusion
• Vascular patient with aortic stenosis • Child with stuffy nose for urological procedure • COPD and laparocopic colectomy
• Adolescent head injury victim • Child with malfunctioning CSF Shunt • Myasthenia gravis and thyroidectomy
• Parturient with severe congenital scoliosis • Child with multiple procedures outside the operating room • The “ICU disaster” patient for exploratory laparotomy
• Asthmatic patient for open bariatric surgery • Cataract repair and uncontrolled hypertension • The patient who asks for propofol and BIS monitoring
• Anticoagulated patient undergoing hip surgery • Octagenarian with atrial fibrillation for TURP • Outpatient undergoing extensive liposuction
• Parturient with HELLP syndrome for emergency cesarean section • Bradycardia and hypoxemia during tonsillectomy • Preoperative cardiac dysfunction
• Cardiomyopathy and sleep apnea syndrome • Epidural in a febrile parturient • Pain after brachial plexus block
• Brittle diabetic for spine surgery • Failed block • Patient with cervical spine instability
• Bronchoscopy for anterior mediastinal mass • ST segment changes during radical neck dissection • Refractory pain after total knee arthroplasty
• Child with VSD for fracture treatment • Adult patient with epiglottitis • Hypotension after tourniquet release



    Armin Schubert, M.D., is Professor of Anesthesiology, Cleveland Clinic Health Sciences Campus of the Ohio State University, Cleveland, Ohio.
Armin Schubert, M.D.



    John E. Tetzlaff, M.D., is a Staff Anesthesiologist, The Cleveland Clinic Foundation, Cleveland, Ohio.
John E. Tetzlaff, M.D.

 

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