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  1. Article ; Online: Competency-Based Medical Training in Anesthesiology: Has It Delivered on the Promise of Better Education?

    Kealey, Alayne / Naik, Viren N

    Anesthesia and analgesia

    2022  Volume 135, Issue 2, Page(s) 223–229

    MeSH term(s) Anesthesiology/education ; Clinical Competence ; Curriculum ; Education, Medical, Graduate ; Internship and Residency
    Language English
    Publishing date 2022-07-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80032-6
    ISSN 1526-7598 ; 0003-2999
    ISSN (online) 1526-7598
    ISSN 0003-2999
    DOI 10.1213/ANE.0000000000006091
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  2. Article ; Online: The influence of resident and faculty gender on assessments in anesthesia competency-based medical education.

    Matava, Clyde T / Alam, Fahad / Kealey, Alayne / Bahrey, Lisa A / McCreath, Graham A / Walsh, Catharine M

    Canadian journal of anaesthesia = Journal canadien d'anesthesie

    2023  Volume 70, Issue 6, Page(s) 978–987

    Abstract: Purpose: Competency-based medical education (CBME) relies on frequent workplace-based assessments of trainees, providing opportunities for conscious and implicit biases to reflect in these assessments. We aimed to examine the influence of resident and ... ...

    Title translation L’influence du genre des résident·es et des professeur·es sur les évaluations de la formation médicale fondée sur les compétences en anesthésie.
    Abstract Purpose: Competency-based medical education (CBME) relies on frequent workplace-based assessments of trainees, providing opportunities for conscious and implicit biases to reflect in these assessments. We aimed to examine the influence of resident and faculty gender on performance ratings of residents within a CBME system.
    Methods: This retrospective cohort study took place from August 2017 to January 2021 using resident assessment data from two workplace-based assessments: the Anesthesia Clinical Encounter Assessment (ACEA) and Entrustable Professional Activities (EPAs). Self-reported gender data were also extracted. The primary outcome-gender-based differences in entrustment ratings of residents on the ACEA and EPAs-was evaluated using mixed-effects logistic regression, with differences reported through odds ratios and confidence intervals (α = 0.01). Gender-based differences in the receipt of free-text comments on the ACEA and EPAs were also explored.
    Results: In total, 14,376 ACEA and 4,467 EPA assessments were analyzed. There were no significant differences in entrustment ratings on either assessment tool between men and women residents. Regardless of whether assessments were completed by men or women faculty, entrustment rates between men and women residents were not significantly different for any postgraduate year level. Additionally, men and women residents received strengths-related and actions-related comments on both assessments at comparable frequencies, irrespective of faculty gender.
    Conclusion: We found no gender-based differences in entrustment ratings for both the ACEA and EPAs, which suggests an absence of resident gender bias within this CBME system. Given considerable heterogeneity in rater leniency, future work would be strengthened by using rater leniency-adjusted scores rather than raw scores.
    MeSH term(s) Humans ; Male ; Female ; Internship and Residency ; Retrospective Studies ; Sexism ; Competency-Based Education ; Faculty, Medical ; Anesthesia ; Clinical Competence
    Language English
    Publishing date 2023-05-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 91002-8
    ISSN 1496-8975 ; 0832-610X
    ISSN (online) 1496-8975
    ISSN 0832-610X
    DOI 10.1007/s12630-023-02454-x
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  3. Article ; Online: Validity evidence for the Anesthesia Clinical Encounter Assessment (ACEA) tool to support competency-based medical education.

    Kealey, Alayne / Alam, Fahad / Bahrey, Lisa A / Matava, Clyde T / McCreath, Graham A / Walsh, Catharine M

    British journal of anaesthesia

    2022  Volume 128, Issue 4, Page(s) 691–699

    Abstract: Background: Workplace-based assessment (WBA) is key to a competency-based assessment strategy. Concomitantly with our programme's launch of competency-based medical education, we developed an entrustment-based WBA, the Anesthesia Clinical Encounter ... ...

    Abstract Background: Workplace-based assessment (WBA) is key to a competency-based assessment strategy. Concomitantly with our programme's launch of competency-based medical education, we developed an entrustment-based WBA, the Anesthesia Clinical Encounter Assessment (ACEA), to assess readiness for independent practice of competencies essential to perioperative patient care. This study aimed to examine validity evidence of the ACEA during postgraduate anaesthesiology training.
    Methods: The ACEA comprises an eight-item global rating scale (GRS), an overall independence rating, an eight-item checklist, and case details. ACEA data were extracted for University of Toronto anaesthesia residents from July 2017 to January 2020 from the programme's online assessment portal. Validity evidence was generated following Messick's validity framework, including response process, internal structure, relations with other variables, and consequences.
    Results: We analysed 8664 assessments for 137 residents completed by 342 assessors. From generalisability analysis, 10 independent observations (two assessments each from five assessors) were sufficient to achieve a reliability threshold of ≥0.70 for in-training assessments. A composite GRS score of 3.65/5 provided optimal sensitivity (93.6%) and specificity (90.8%) for determining entrustment on receiver operator characteristic curve analysis. Test-retest reliability was high (intraclass correlation coefficient [ICC
    Conclusions: This study supports the validity of the ACEA for assessing the competence of residents performing perioperative care and supports its use in competency-based anaesthesiology training.
    MeSH term(s) Anesthesia ; Anesthesiology/education ; Clinical Competence ; Education, Medical ; Educational Measurement ; Humans ; Internship and Residency ; Reproducibility of Results
    Language English
    Publishing date 2022-01-10
    Publishing country England
    Document type Journal Article
    ZDB-ID 80074-0
    ISSN 1471-6771 ; 0007-0912
    ISSN (online) 1471-6771
    ISSN 0007-0912
    DOI 10.1016/j.bja.2021.12.012
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  4. Article ; Online: Association Between Anesthesiologist Sex and Patients' Postoperative Outcomes: A Population-based Cohort Study.

    Jerath, Angela / Satkunasivam, Raj / Kaneshwaran, Kirusanthy / Aminoltejari, Khatereh / Chang, Ashton / MacDonell, D Su-Yin / Kealey, Alayne / Ladowski, Stephanie / Sarmah, Anita / Flexman, Alana M / Lorello, Gianni R / Nabecker, Sabine / Coburn, Natalie / Conn, Lesley G / Klaassen, Zachary / Ranganathan, Sanjana / Riveros, Carlos / McCartney, Colin J L / Detsky, Allan S /
    Wallis, Christopher J D

    Annals of surgery

    2024  Volume 279, Issue 4, Page(s) 569–574

    Abstract: Objective: To examine the association of anesthesiologist sex on postoperative outcomes.: Background: Differences in patient postoperative outcomes exist, depending on whether the primary surgeon is male or female, with better outcomes seen among ... ...

    Abstract Objective: To examine the association of anesthesiologist sex on postoperative outcomes.
    Background: Differences in patient postoperative outcomes exist, depending on whether the primary surgeon is male or female, with better outcomes seen among patients treated by female surgeons. Whether the intraoperative anesthesiologist's sex is associated with differential postoperative patient outcomes is unknown.
    Methods: We performed a population-based, retrospective cohort study among adult patients undergoing one of 25 common elective or emergent surgical procedures from 2007 to 2019 in Ontario, Canada. We assessed the association between the sex of the intraoperative anesthesiologist and the primary end point of the adverse postoperative outcome, defined as death, readmission, or complication within 30 days after surgery, using generalized estimating equations.
    Results: Among 1,165,711 patients treated by 3006 surgeons and 1477 anesthesiologists, 311,822 (26.7%) received care from a female anesthesiologist and 853,889 (73.3%) from a male anesthesiologist. Overall, 10.8% of patients experienced one or more adverse postoperative outcomes, of whom 1.1% died. Multivariable adjusted rates of the composite primary end point were higher among patients treated by male anesthesiologists (10.6%) compared with female anesthesiologists (10.4%; adjusted odds ratio 1.02, 95% CI: 1.00-1.05, P =0.048).
    Conclusions: We demonstrated a significant association between sex of the intraoperative anesthesiologist and patient short-term outcomes after surgery in a large cohort study. This study supports the growing literature of improved patient outcomes among female practitioners. The underlying mechanisms of why outcomes differ between male and female physicians remain elusive and require further in-depth study.
    MeSH term(s) Adult ; Humans ; Male ; Female ; Anesthesiologists ; Cohort Studies ; Retrospective Studies ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Ontario/epidemiology
    Language English
    Publishing date 2024-01-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 340-2
    ISSN 1528-1140 ; 0003-4932
    ISSN (online) 1528-1140
    ISSN 0003-4932
    DOI 10.1097/SLA.0000000000006217
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  5. Article ; Online: Real-world impact of the COVID-19 pandemic on the assessment of anaesthesiology residents.

    Kealey, Alayne / Alam, Fahad / McCreath, Graham / Matava, Clyde T / Bahrey, Lisa A / Walsh, Catharine M

    British journal of anaesthesia

    2020  Volume 125, Issue 5, Page(s) e430–e432

    MeSH term(s) Anesthesiology/education ; Betacoronavirus ; COVID-19 ; Clinical Competence/statistics & numerical data ; Coronavirus Infections/prevention & control ; Educational Measurement/methods ; Humans ; Internship and Residency/methods ; Internship and Residency/statistics & numerical data ; Pandemics/prevention & control ; Pneumonia, Viral/prevention & control ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-08-20
    Publishing country England
    Document type Letter ; Research Support, Non-U.S. Gov't
    ZDB-ID 80074-0
    ISSN 1471-6771 ; 0007-0912
    ISSN (online) 1471-6771
    ISSN 0007-0912
    DOI 10.1016/j.bja.2020.08.016
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  6. Article: Real-world impact of the COVID-19 pandemic on the assessment of anaesthesiology residents

    Kealey, Alayne / Alam, Fahad / McCreath, Graham / Matava, Clyde T / Bahrey, Lisa A / Walsh, Catharine M

    Br J Anaesth

    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #722665
    Database COVID19

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  7. Article ; Online: Real-world impact of the COVID-19 pandemic on the assessment of anaesthesiology residents

    Kealey, Alayne / Alam, Fahad / McCreath, Graham / Matava, Clyde T. / Bahrey, Lisa A. / Walsh, Catharine M.

    British Journal of Anaesthesia

    2020  Volume 125, Issue 5, Page(s) e430–e432

    Keywords Anesthesiology and Pain Medicine ; covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    ZDB-ID 80074-0
    ISSN 1471-6771 ; 0007-0912
    ISSN (online) 1471-6771
    ISSN 0007-0912
    DOI 10.1016/j.bja.2020.08.016
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