Anesthesia — Transition to Discipline

TTD1a Performing preoperative assessments for healthy adult patients who will be undergoing a non-complex scheduled surgical procedure - part A: Patient assessment Direct observation or chart/case review by supervisor

Key Features:
- This EPA includes:
1) Establishing rapport with the patient who is scheduled for a non-complex surgery
2) Effectively gathering the data required for safe conduct of anesthesia
3) Organizing information appropriately in the anesthetic chart
4) Recognizing when to seek help in providing clear explanations to the
patient
- The observation of this EPA is divided into two parts: supervisor observation of
patient assessment; submission of a logbook of preoperative assessments.
Relation with other EPAs: This EPA is a preparatory step to the Foundations EPA on «using the anesthetic assessment to generate the anesthetic considerations» which deals with data interpretation and synthesis and the Foundations EPA on «providing perioperative anesthetic management» which deals with application of the data gathered to deliver an anesthetic. Performing the preoperative assessment is also part of the EPA on «providing perioperative anesthetic management»

Form

F1: Observation

Milestones

• ME 2.2. Elicit a history including relevant past medical history, review of old records, anesthetic history and functional review of systems

• ME 2.2. Perform a pre-anesthetic physical examination, including an airway assessment

• ME 2.2. Identify relevant investigations required prior to the scheduled minor procedure

• COM 1.1. Communicate in a way that encourages patient trust and autonomy and is characterized by empathy, respect, and compassion

• COM 1.4. Identify, verify and validate non-verbal cues on the part of patients and their families

• ME 2.2. Conduct a focused and efficient patient interview, managing the flow of the encounter while being attentive to the patient’s cues and responses

• ME 3.1. Communicate the plan of care in a clear, compassionate, respectful, and accurate manner to the patient and family

• COM 3.1. Recognize when to seek help in providing clear explanations to the patient and family

• COM 4.1. Communicate with cultural awareness and sensitivity

• COM 4.3. Demonstrate steps to obtaining informed consent

• ME 2.2. Synthesize clinical information for presentation to a supervisor in an organized manner

• COM 5.1. Organize information in appropriate sections within an electronic or written medical record

• COL 2.1. Convey information thoughtfully

• COL 2.1. Respond to requests and feedback in a respectful and timely manner

• S 1.1. Describe physicians’ obligations for lifelong learning and ongoing enhancement of competence

• P 1.1. P 1.1 Prioritize the needs of patients and others to ensure a patient’s legitimate needs are met

• P 1.1. P 1.1 Demonstrate punctuality

• P 1.1. P 1.1 Complete assigned responsibilities in a timely fashion

Context Variables

• Age of patient (free-text)
• Type of observation (single-choice)
  • direct
  • chart/case review
• Type of surgical procedure (single-choice)
  • urology
  • gynecology
  • ophthalmology
  • other surgery
  • otolaryngology
  • general surgery
  • plastic surgery
  • orthopedic surgery

Requirements

• Collect a minimum of 3 observations (minimum 3)