he Society for Obstetric Anesthesia and Perinatology (SOAP) Education Committee was formed in 1995 with the charge to develop, assist, coordinate and publicize the educational objectives, programs and activities of the society. Ten years later, the committee has grown not only in member numbers but also in scope. Presently the committee is a lively mix of 30 academic and private practice anesthesiologists who meet at the ASA and SOAP annual meetings. As the committee chair, I would like to update you on some of the recent committee projects and activities.

The Education Committee contributes regularly to the SOAP newsletter, which is published three times a year. Committee members volunteer to serve as authors, and the published articles primarily take one of three forms. Review articles cover clinically relevant topics. Recent articles have included “Neurological Complications of Regional Anesthesia in Obstetrics” (such complications are the leading cause of legal action against anesthesiologists practicing obstetric anesthesiology), “Management of Postdural Puncture Headache,” “The Parturient of Advanced Maternal Age,” “Informed Consent and Language Issues,” “Cardiac Arrest in Labor and Delivery,” “Crystalloid Prehydration: Time for Change in Our Practice?” and “Peripartum Cardiomyopathy.”

The second type of article in the SOAP newsletter is the perennially popular “pro/con” piece. Recent debates include: “Should a healthy pregnant woman be considered an ASA I or an ASA II?,” “Should parturients presenting in active labor be considered category E (for emergency)?” and “Is ephedrine still the vasopressor of choice for spinal anesthesia-induced hypotension in obstetrics?” Finally, the last format is the newly developed “How Would I Manage This Case?” in which SOAP members describe how they would proceed with difficult cases and thorny clinical dilemmas. All of these newsletter articles are available to both SOAP members and nonmembers at <www.soap.org>.

Another interesting activity of the SOAP Education Committee is support of Accreditation Council for Graduate Medical Education (ACGME) accreditation for obstetric anesthesiology fellowship training. ACGME requirements for subspecialty training program accreditation are as follows:

• The existence of a body of scientific medical knowledge underlying the subspecialty; knowledge that is in large part distinct from or more detailed than that of other areas in which accreditation is already offered. The body of knowledge must be sufficient for educating individuals in a clinical field, not just in one or more techniques.

• The existence of a sufficiently large group of physicians concentrating their practices in the proposed subspecialty area. Required information includes the number of physicians, the annual rate of increase in the past decade and their present geographic distribution.

• The existence of national medical societies with a principal interest in the proposed subspecialty area. Information should include the number of refereed journals published in the subspecialty area as well as how many national and regional meetings are held annually.

• The regular presence in academic units and health care organizations of educational programs, research activities and clinical services so that the subspecialty is broadly available on a national basis to sufficiently improve the quality of health care by providing high standards of medical education.

• The evolution of the subspecialty area to the extent that the projected number of programs to be accredited will be sufficient to ensure that accreditation is a cost-effective method of quality control.
• Duration of training is a minimum of one year in addition to the core requirements and that the educational program is primarily clinical.

• The impact of accrediting programs in the petitioning or proposed subspecialty area has no adverse impact upon programs of the primary specialty or adverse impact upon other disciplines.¹

In preparation for possible application, the SOAP Education Committee has developed (and recently updated) “Program Requirements for Subspecialty Training in Obstetric Anesthesiology.” This document outlines clinical and educational facilities and resources, educational goals and objectives, clinical and didactic components, duty hours, and scholarly and research activity for obstetric fellowship training programs. The Education Committee is prepared to assist with this initiative as needed in the future.

Another accomplishment of the Education Committee has been the Research in Education Award that recognizes research in specific educational techniques and tools (including multimedia). In addition this award also acknowledges development of instruments for evaluation of outcomes or other innovative and creative investigations that impact the quality of obstetric anesthesiology education. All SOAP members or those sponsored by a SOAP member are eligible for this award. Submitted abstracts may focus on the education of medical students, residents, patients, obstetric care providers or the community. The award winner is announced at the SOAP Annual Meeting and receives a $500 monetary award.

The first year that this award was given (2002), there was a tie vote, and awards were given to David J. Birnbach, M.D. (“The Use of Videotapes of Specific Errors as an Adjunct to Teach Epidural Technique”) and to the father-and-son team of Raymond Glassenberg, M.D., and Sam Glassenberg, M.S. (“The Virtual Larynx”). In 2003 the award was again received by the Glassenbergs (“The Virtual Spine”). The 2004 winner was Michelle Sproviero, M.D. (“Development of a Unified Assessment Tool for Measuring Resident Performance During an Obstetric Anesthetic Scenario on a High-Fidelity Human Patient Simulator”). All of the winning abstracts have been both innovative and of very high quality. (Authors may submit abstracts to the SOAP Annual Meeting. To be considered for this award, simply check the box for the “Research in Education Award” on the electronic abstract submission form. The abstract submission deadline for SOAP is in January each year.)

In addition to our work with the SOAP newsletter, ACGME accreditation preparation and the Research in Education Award, the Education Committee continues to be very supportive of obstetric anesthesiology international outreach efforts. The committee’s earliest involvement was with the ASA’s Overseas Teaching Program. Education Committee member Medge D. Owen, M.D., developed an outstanding Neonatal Resuscitation Course adapted to the local circumstances in Ghana, Africa. This program was successfully used to train more than 100 local physicians, nurse anesthetists and midwives with a “teach-the-teacher” emphasis. Since the time of the initial visit in 2003, the course has been taught to other health care practitioners in the surrounding areas. Dr. Owen also is actively involved with teaching obstetric anesthesiology and regional techniques to physicians in Turkey and Croatia, where she has been very successful not only with teaching but also in building local networks of support. We are very pleased that Dr. Owen now chairs the newly formed SOAP International Outreach Committee. Anesthesiologists interested in volunteering for overseas obstetric educational initiatives may contact her at <mowen@wfubmc.edu>.

In summary the SOAP Education Committee is an active and engaged group of anesthesiologists with a commitment to our subspecialty and to the education of anesthesiology practitioners and trainees, obstetric care providers and patients. We welcome all practitioners with an interest in obstetric anesthesiology to our 37th Annual Meeting, which will be held at the J.W. Marriott Resort and Spa in Palm Desert, California, on May 4-7, 2005.

Reference:
1. Accreditation Council for Graduate Medical Education Web site <www.acgme.org>.

Linda S. Polley, M.D., is Clinical Associate Professor and Director, Obstetric Anesthesiology, Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan.