A survey of mentorship among Canadian anesthesiology residents.

IntroductionMentorship in medicine is associated with increased career satisfaction and personal development. Despite these benefits, little is known about mentorship in anesthesiology training programs. Our objectives were to determine (1) the prevalence of formal mentorship programs among anesthesiology training programs in Canada, (2) the prevalence of informal and formal mentorship among anesthesiology residents in Canada, and (3) the predictors of having an identified mentor among anesthesiology residents in Canada.MethodsWe conducted a cross-sectional web-based survey of residents and program directors from Canadian anesthesiology residency programs. Program directors were questioned about formal mentorship programs, and residents were asked to provide demographic data and information about their mentorship relationships. We analyzed the relationship between resident characteristics and mentorship.ResultsOur survey response rates were 76% and 39% for the Program Director Survey and the Resident Survey, respectively. Formal mentorship programs were present in 54% of residency training programs, and 94% of residents agreed that mentorship was important. Seventy-four percent of residents identified at least one mentor, although 42% of these residents did not interact regularly with their mentor. Mentors and mentees were more likely to be of the same gender. If a formal mentorship program was present, residents were more likely to identify a mentor (82 vs 17%) and interact regularly with their mentor (70 vs 46%).ConclusionsFormal mentorship programs were present in half of anesthesiology training programs. Although 74% of the residents identified a mentor, 42% did not interact regularly with their mentor. The presence of a formal mentorship program was positively associated with mentorship

Knowledge and perceptions about perioperative stroke: a cross-sectional survey of patients scheduled for non-neurologic and non-cardiac surgery.

PurposePerioperative stroke is associated with significant morbidity and mortality yet patients may not be aware of their risk or receive appropriate counselling. Our objectives were to 1) compare patient's perceived vs calculated risk of stroke; 2) determine level of worry; and 3) assess prior discussion about perioperative stroke risk amongst elective patients undergoing non-cardiac, non-neurologic surgery.MethodsOver a consecutive four-week period, surveys were distributed at two pre-anesthetic clinics to adult patients scheduled for non-cardiac, non-neurologic surgery. The survey included questions about demographics, perioperative stroke risk factors, patient perception of their quantitative and qualitative stroke risk, level of worry about stroke, and risk discussions. We identified independent predictors of risk underestimation amongst medium- and high-risk patients.ResultsSix hundred patients completed the survey (response rate 78%). Of these, 479, 104, and 15 patients were classified as low-, medium-, and high-risk, respectively (with two patients missing this data point). Most medium- (86%) and high-risk (80%) patients did not identify their elevated risk. Amongst medium- and high-risk patients, independent predictors of risk underestimation were lower education and absence of kidney disease. Medium- and high-risk patients were more worried than low-risk patients about perioperative stroke (median [interquartile range] visual analogue scale score 2 [0.5-4] vs 1 [0-2], P = 0.001). Fewer than half of patients had discussed perioperative stroke previously (40%, 23%, and 12% of high-, medium-, and low-risk patients, respectively).ConclusionsPatients at higher risk of stroke frequently underestimate their risk of perioperative stroke. The majority of patients had not discussed perioperative stroke prior to anesthetic consultation

A comparison of droplet and contact contamination using 3 simulated barrier techniques for COVID-19 intubation : a quality assurance study

Background: The intubation of patients with coronavirus disease 2019 (COVID-19) puts health care workers at risk of infection through aerosol, droplet and contact contamination. We evaluated the risk of droplet and contact contamination for health care workers using 3 intubation barrier techniques as part of a quality assurance study at our institution. Methods: This randomized quality assurance study was completed at a tertiary academic hospital in Vancouver, British Columbia, Canada, on Apr. 4, 2020. Participants in personal protective equipment performed simulated intubations on a manikin with (a) no barrier, (b) a clear plastic sheet covering the manikin and (c) a plexiglass intubation box over the manikin, in random order. Fluorescein was ejected from inside the manikin’s mouth to simulate droplet and contact spread during a standard intubation sequence. Two blinded independent assessors evaluated the location and degree of contamination on the intubator and assistant using an ultraviolet light. Contamination severity was rated in a standard fashion (0 = none; 1 = minor; 2 = major). The primary outcome was total contamination score and secondary outcomes were scores between intubator and assistant, anatomic areas contaminated and qualitative feedback on ease of intubation. Results: Five participants completed this study. Total contamination score was different between the 3 groups for the intubator (p = 0.02) but not the assistant (p = 0.2). For the intubator, the total contamination score was higher when the sheet was used (median 29 [interquartile range (IQR) 25–34]) than when the box was used (median 17 [IQR 15–22]) or when no barrier was used (median 18 [IQR 13–21]). All 5 participants reported challenges during intubation using the sheet. Interpretation: Use of a plastic sheet while intubating patients with COVID-19 may increase the risk of droplet and contact contamination during intubation and impede intubation. Further study should be undertaken before implementing barrier techniques in practice.Medicine, Faculty ofNon UBCAnesthesiology, Pharmacology and Therapeutics, Department ofReviewedFacultyResearche

Neuroanesthesia practice during the COVID-19 pandemic: recommendations from Society for Neuroscience in Anesthesiology and Critical Care (SNACC)

The pandemic of coronavirus disease 2019 (COVID-19) has several implications relevant to neuroanesthesiologists, including neurologic manifestations of the disease, impact of anesthesia provision for specific neurosurgical procedures and electroconvulsive therapy, and healthcare provider wellness. The Society for Neuroscience in Anesthesiology and Critical Care appointed a task force to provide timely, consensus-based expert guidance for neuroanesthesiologists during the COVID-19 pandemic. The aim of this document is to provide a focused overview of COVID-19 disease relevant to neuroanesthesia practice. This consensus statement provides information on the neurological manifestations of COVID-19, advice for neuroanesthesia clinical practice during emergent neurosurgery, interventional radiology (excluding endovascular treatment of acute ischemic stroke), transnasal neurosurgery, awake craniotomy and electroconvulsive therapy, as well as information about healthcare provider wellness. Institutions and healthcare providers are encouraged to adapt these recommendations to best suit local needs, considering existing practice standards and resource availability to ensure safety of patients and providers