Feedback and Self-reflection

This week the faculty has its internal education audit for the department and school within the faculty. The process usually begins with the presentation by department chair and the education team, then the auditor/ surveyor asks some questions either from the evaluation guide or from the self-assessment report submitted by each department to the organising committee.

Then in the interview process; the auditor may ask some presentative from consultants, learners from undergraduate medical student to nurse student to residents to MSc/PhD candidates, and department educator team. Then the surveyor review the documents prepared by the department member, they can be the schedule of curriculum, document and objectives of learning for each topic, examples of the final test, student evaluation form.

In the learner's view points, they usually would love to have feedback from their supervisor which can be consultant working with them, nurses helping them or other staff member who they are working with. A good feedback or even a destructive one is essential for the learning process, it can make things a complete circle, points some ideas the learners never have thought of or have looked over. The coaching day for the resident organised within our department is another way so that consultant can have time to look after the resident, guide something they did not quite acceptable in the consultant 's eyes, or give them a pride if they have done something really good.

Adequate supervision helps in the learning process, it also helps diminish some avoidable complications, so it directs patient safety.

Self-reflection is also help yourself the learner, know what you really need in particular field so that you can jump or run into some patients to learn more in the area you have not done good or in the less experienced field that you do have to improve it. If you can have both feedback and self-reflection, you should be very happy and have a really good day, although it is Halloween today.

Anatomy in VID

Although in the clinical year education medical students would not have formal education in basic sciences, but you have to realise that it is well cooperated in the various field of disciplines. When you are having your time in surgery, you are totally in the time of anatomy review, you have to recognise where the pathology is and any close associated organs nearby.

In the anaesthetics rotation besides anatomy of the airway, peripheral nerves, cardiovascular tree, you have to understand your patient anatomy so that you will have a clear plan about what you have to do during your care for him/her in the operating theatre, for example, in the video up here, you would need to know the arterial supply of the lower extremities, so that you can plan and have vigilance about what you should do and understand the surgical procedure as well.

Unhappiness from Students

This morning the department was visited by a committee from the faculty, the Internal Education Survey which was kicked off on Monday. The committee was welcomed by our chairperson, and she presented the things done in the previous academic for three learner levels; medical student, anaesthesia resident, and anaesthesia nurse trainee. Then the head of postgraduate anaesthesia training presented all anaesthesia education of all three teams. The history of what happened in the past such as curriculum for medical student, the rotation, the changed learning climate, the changed learners were all discussed and presented to the surveyors.

Then the surveyors interviewed the department board in education, asked our chair about her leadership role and what our department could bring about the social responsibility.

One thing the surveyor team suggested us to perform is the evaluation of Unhappiness from our learners which applied to all three levels, but the nurse education team has led the others, they have already measured the unhappiness from our trainees.

So, action and plan next for undergraduate education team is to learn how we could do to perform this unhappiness in our medical student which has quite a small amount of their time with us.

What is helpful for the judgement of Unhappiness? There has been a research showed that engagement to the team member could help attenuate the unhappiness. By clicking here can lead you to online article about happiness and unhappiness. Team helps because there must be something in common before working as a team member, you have to work with each of everyone belonged to the group, and each has their own roles to perform with a unique identity.

Anaesthesia and Burn

Burn from any cause is definitely harm to your patient, skin is considered not an important vital organ, however, skin is essential to protect your internal organ and prevent heat and fluid loss. When your patient has problems with his/her skin, insensible fluid losses together with visible fluid loss can precipitate your patient's homaeostasis.

When you have to evaluate your burn patient, you have to establish two things, one is degree of tissue injury, the severity of burn from 1st degree to 3rd degree. Then you have to estimate the extent of the injury, the percentage of your patient's skin involved relative to total body surface area. This will have to be examined because it is essential for the treatment plan you patient is in need.

Further anaesthetic considerations for the management of your burn patient will include; what type of injury such as flame, acid, or electrical because the consequences of each cause would be different, and also when the injury happened either acute injury or in the convalescence phase. The scar from chronic wound would definitely affect your decision on how to intubate your patient such as the lower photo here. If your patient is scheduled for skin graft, you have to ask also where the donor skin will come from and which position your patient will be required.

Burn management is very difficult however it is a very challenging discipline. Get it or Lose it.

Communication Skill : Essential part for 21st Century Learnersf

Today in the summative evaluation period for group 16/2555 we discussed about communication skill for medical students. One student mentioned about the current core curriculum does not have enough time slot dedicating for communication practice, and she let us know that in Taiwan there is such a slot for doing the councelling for 2 weeks.

Although we do not have that slot, in my opinion we can do it anytime during their clinical rotation not only the ward rounds, during out patient clinic the student can have a chance to practice that. Even a short 2 week rotation for anaesthetics, if you have time to visit your patient before the operation, you can really learn from that moment, especially if you run into Anaesthesia Residents doing their preoperative evaluation routine near you, you should jump in this chance and chat with them, they would be very happy to answer if you have appropriate questions about why they order that treatment or do that intervention for the patients.

Preoperative evaluation is an essential heart for the practice of anaesthesia, you have a chance to meet your patients which is different from the surgical team which they have known each other for ages. You can have a chance to discuss choice of anaesthesia, plan in mind what you would do, what you will not to participate as a member of the team.

Communication is very important, sometimes you do have to speak out loud!! otherwise others would not understand you, they may think you do not say anything means that you have already accepted, have known it, because consultants may have "don't ask, don't tell" policy. The Culture of Seniority does not mean that you should not speak, it would mean that you have to speak at the right time, ask if you do not understand, speak if you think that something is going out of the way it should be. Speak out before it is too late and ทุเรศ. You do have to.

Access to reach 4000 Today

After being with you for nearly three years now, from the very inactive blog has become a nearly 1000 access hits a month. The rate of reading is better than it was, however, I do not have much ideas what I should put up here, thinking the best I would try to write whatever it suits the aimed audiences, the medical students and their small world of Anaesthesia.

Keep walking and keep posting, thanks for being with us.

Simulation Class of group 15/2555

From last Wednesday, October 3rd 2555, the students of the group 15 were with us to their class of simulation. Staff of the day was so energetic and played an important role.

The introduction period: Time to review the physical examination, abnormal auscultation both cardiac murmurs and adventitious breath sounds.

I do not listen to you now, because you do have to listen to me, you have to do whatever you need to in order to save my mom's life. The scene in the class, the situations ran, the flow of action followed.

Debriefing : Time to appreciate what students had done something good, time to reconsider if there was something went out from the normal way, so that the learners can educate themselves and understand why sometimes it had to learn from failure.

Although they were not the team member during the scenerio, but they had discussed what went wrong with the monitoring and what should have done to pull our patient back.

The action by our Staff in Chief, she had done many things, rearranged the scene, asked technician and secretary to participate with the show.

MCQ the Comprehensive Examination for 6th year Student

A workshop is organised by the faculty to improve and edit the MCQ examination submitted by faculty members. Lots of discussion, edit the text, some questions can be improve, some has to return to the owner because they are inappropriate, does not initiate thinking process, asks only the recall.

From basics to Bedsides: The Critical Care Meeting in December

Annual Meeting Dec2555

This year theme for the conference organised by the Thai Society of Critical Care Medicine in December is to promote the background knowledge for improvement and better patient management. Such as the management of shock runs from basic sciences to fluid management, how to resuscitate the patient in shock, what is happening during shock, how to monitor the patient's responsiveness, how to titrate the response and how you would do to attenuate the complications from shock management.

The second day is about the basic in ventilator management, mechanical assisted device for shock management, ARDS and sepsis. This day also includes the surgical patients who need perioperative critical care therapy.

If you would like to know more, the link to the website is on the uppermost corner.

The Simulation clip

On Wednesday 3rd that we taught med students with this technique, it was quite a pity that the audio system was down so we cannot keep the sound, otherwise the visual view was quite all right. We would like to share with you the event happened a couple of days ago.

The anaesthetic consultant had played an important role in that day, both tricks and treats on the students.

Hope that you would not mind with the sound.

Today Simulation Class

The climate of learning for today simulation learning in our department was so fun, because the anaesthesia consultant in charge had tried her best for the teaching process. She initiated the thinking process and encouraged the learners to think, although it may be both tricks and treats, but overall the session was good, and we would like to thank you our consultant to make such a good teaching and learning day.