Abstract
The shift to direct entry into residency training from medical school for all graduates will offer new challenges for anaesthesia training programmes. In this paper we argue that it also offers us an opportunity to re-evaluate our current approach to anaesthesia education. Emphasis in the residency programmes should be to provide trainees with clinical experiences and stimulation that will develop the required traditional competencies. It should also cultivate competency in clinical decision-making, intuition and judgement. Our purpose is to generate discussion by proposing an alternate curriculum model, the experiential curriculum. The basic premise is that learning is a process and outcome is to a large extent related to what the learner does. The process begins with an experience that provides for observation and reflection. Integration of the thoughts provides the basis for executing either existing or new actions. In the experiential curriculum residency training and learning are enhanced by documenting and critically evaluating the experiences to which the resident is exposed. Included within such a structured programme are the methodologies of problem-based and evidence-based learning. Faculty development will be required to help the resident pursue these skills of self-evaluation and efficient learning. We believe that incorporation of an experiential curriculum into the residency training programme will achieve the goals listed above and allow maturation of the process of lifelong learning. It will also allow greater achievement of the application of new information to one’s practice.
Résumé
L’évolution de la formation vers l’accès direct à la résidence à partir de l’école de médecine pour tous les diplômés représente une nouveau défi pour les programmes d’enseignement de l’anesthésie. Cet article nous offre l’opportunité de réévaluer notre attitude actuelle vis-à-vis la formation en anesthésie. Les programmes d’anesthésie doivent fournir à leurs étudiants en formation des expériences cliniques et les stimuler dans le but de les faire assimiler les compétences traditionnelles. Ils devraient aussi se former à prendre les décisions cliniques appropriées et à acquérir de l’intuition et du jugement. Notre objectif est de susciter la discussion en proposant un modèle de curriculum de rechange, le curriculum expérientiel. La prémisse initiale consiste en ce que l’éducation est un processus et que ses résultats dépendent largement de l’apprentissage. Le processus débute avec une expérience qui fournit observation et réflexion. L’intégration des idées constitue la base de l’exécution d’actions existantes ou nouvelles. Dans le curriculum expérientiel pour la résidence en l’anesthésie, la formation et l’acquisition de connaissances sont consolidées par la documentation et l’évaluation critique des expériences auxquelles le résident est exposé. Les méthodes d’enseignement basées sur l’étude de problèmes et sur la démonstration sont comprises dans ce genre de programme. Le corps enseignant doit évoluer et permettre au résident de poursuivre ces aptitude d’autocritique et d’apprentissage. Nous croyons que l’incorporation du curriculum expérientiel au programme de formation du résident atteindra les objectifs décrits plus haut et permettra la maturation du processus perpétuel de l’acquisition des connaissances. Elle permettra de plus réaliser plus facilement l’application de nouvelles connaissance à sa pratique.
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Tweed, W.A., Donen, N. The experiential curriculum: an alternate model for anaesthesia education. Can J Anaesth 41, 1227–1233 (1994). https://doi.org/10.1007/BF03020667
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DOI: https://doi.org/10.1007/BF03020667