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 |
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Armin
Schubert, M.D., is Professor of Anesthesiology,
Cleveland Clinic Health Sciences Campus of the
Ohio State University, Cleveland, Ohio. |
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John
E. Tetzlaff, M.D., is a Staff Anesthesiologist,
The Cleveland Clinic Foundation, Cleveland,
Ohio. |
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