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  1. Article: Decision Making in Obstetric Anesthesia.

    Minehart, Rebecca D / Katz, Daniel

    Anesthesiology clinics

    2021  Volume 39, Issue 4, Page(s) 793–809

    Abstract: Obstetric anesthesiologists provide care under unique conditions, where frequently unscheduled cases demand flexibility in thinking and acting. And although most obstetric patients may be healthy, they can quickly deteriorate, necessitating rapid team ... ...

    Abstract Obstetric anesthesiologists provide care under unique conditions, where frequently unscheduled cases demand flexibility in thinking and acting. And although most obstetric patients may be healthy, they can quickly deteriorate, necessitating rapid team diagnostic and treatment interventions. Examining decision making is a critical step in improving care to these patients. This article reviews evidence-based models of decision making both with individuals and with teams, and presents strategies to improve decision making under any circumstance.
    MeSH term(s) Anesthesia, Obstetrical ; Anesthesiologists ; Critical Care ; Decision Making ; Female ; Humans ; Patient Care Team ; Pregnancy
    Language English
    Publishing date 2021-10-22
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2228899-5
    ISSN 2210-3538 ; 1932-2275 ; 0889-8537
    ISSN (online) 2210-3538
    ISSN 1932-2275 ; 0889-8537
    DOI 10.1016/j.anclin.2021.08.013
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  2. Article: Effects of Gender and Race/Ethnicity on Perioperative Team Performance.

    Minehart, Rebecca D / Foldy, Erica Gabrielle

    Anesthesiology clinics

    2020  Volume 38, Issue 2, Page(s) 433–447

    Abstract: We judge each other every day using demographic characteristics (such as gender and race/ethnicity), and these social identities shape our lives in profound ways. The impacts of demographic diversity in perioperative teams are poorly understood, and ... ...

    Abstract We judge each other every day using demographic characteristics (such as gender and race/ethnicity), and these social identities shape our lives in profound ways. The impacts of demographic diversity in perioperative teams are poorly understood, and mixed results are reported in other team-based work settings. Drawing from decades' worth of organizational behavior literature, the authors propose a model of critical factors related to interplays between diversity, communication, and conflict, all which take place in a hierarchical environment influenced by power differences. Evidence-based recommendations are provided, aimed at maximizing benefits of diversity in perioperative teams while minimizing negative consequences.
    MeSH term(s) Communication ; Conflict, Psychological ; Female ; Humans ; Male ; Patient Care Team ; Perioperative Care ; Sexism
    Language English
    Publishing date 2020-04-01
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2228899-5
    ISSN 2210-3538 ; 1932-2275 ; 0889-8537
    ISSN (online) 2210-3538
    ISSN 1932-2275 ; 0889-8537
    DOI 10.1016/j.anclin.2020.01.013
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  3. Article: Validating Parallel-Forms Tests for Assessing Anesthesia Resident Knowledge.

    Lee, Allison J / Goodman, Stephanie R / Bauer, Melissa E B / Minehart, Rebecca D / Banks, Shawn / Chen, Yi / Landau, Ruth L / Chatterji, Madhabi

    Journal of medical education and curricular development

    2024  Volume 11, Page(s) 23821205241229778

    Abstract: We created a serious game to teach first year anesthesiology (CA-1) residents to perform general anesthesia for cesarean delivery. We aimed to investigate resident knowledge gains after playing the game and having received one of 2 modalities of ... ...

    Abstract We created a serious game to teach first year anesthesiology (CA-1) residents to perform general anesthesia for cesarean delivery. We aimed to investigate resident knowledge gains after playing the game and having received one of 2 modalities of debriefing. We report on the development and validation of scores from parallel test forms for criterion-referenced interpretations of resident knowledge. The test forms were intended for use as pre- and posttests for the experiment. Validation of instruments measuring the study's primary outcome was considered essential for adding rigor to the planned experiment, to be able to trust the study's results. Parallel, multiple-choice test forms development steps included: (1) assessment purpose and population specification; (2) content domain specification and writing/selection of items; (3) content validation by experts of paired items by topic and cognitive level; and (4) empirical validation of scores from the parallel test forms using Classical Test Theory (CTT) techniques. Field testing involved online administration of 52 shuffled items from both test forms to 24 CA-1's, 21 second-year anesthesiology (CA-2) residents, 2 fellows, 1 attending anesthesiologist, and 1 of unknown rank at 3 US institutions. Items from each form yielded near-normal score distributions, with similar medians, ranges, and standard deviations. Evaluations of CTT item difficulty (item p values) and discrimination (D) indices indicated that most items met assumptions of criterion-referenced test design, separating experienced from novice residents. Experienced residents performed better on overall domain scores than novices (
    Language English
    Publishing date 2024-02-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2798123-X
    ISSN 2382-1205
    ISSN 2382-1205
    DOI 10.1177/23821205241229778
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  4. Article ; Online: Clinical triggers and vital signs influencing crisis acknowledgment and calls for help by anesthesiologists: A simulation-based observational study.

    Matern, Lukas H / Gardner, Roxane / Rudolph, Jenny W / Nadelberg, Robert L / Buléon, Clément / Minehart, Rebecca D

    Journal of clinical anesthesia

    2023  Volume 90, Page(s) 111235

    Abstract: Study objective: In a perioperative emergency, anesthesiologists must acknowledge the unfolding crisis promptly, call for timely assistance, and avert patient harm. We aimed to identify vital signs and qualitative factors prompting crisis acknowledgment ...

    Abstract Study objective: In a perioperative emergency, anesthesiologists must acknowledge the unfolding crisis promptly, call for timely assistance, and avert patient harm. We aimed to identify vital signs and qualitative factors prompting crisis acknowledgment and to compare responses between observers and participants in simulation.
    Design: Prospective, simulation-based, observational study.
    Setting: An anesthesia crisis resource management course at a freestanding simulation center.
    Subjects: Sixty attending anesthesiologists from a variety of practice settings.
    Interventions: In each case, a primary anesthesiologist in charge (PAIC) managed a simulated patient undergoing a uniformly scripted sequence of perioperative anaphylaxis and called for help from another anesthesiologist when a crisis began. Anesthesiologist observers (AOs) viewed the case separately and recorded times of crisis onset.
    Measurements: Simulation footage was reviewed by investigators for patient vital signs and participant behaviors at times of crisis acknowledgment, with the call for help as an explicit proxy for PAIC crisis acknowledgment. These factors were categorized, and group-level data were compared.
    Results: Nineteen PAICs and 41 AOs were included. Clinicians acknowledged crises around a mean arterial pressure (MAP) of 65 mmHg and oxygen saturation of 94% as anaphylactic shock progressed. PAICs acknowledged crises at a higher respiratory rate than AOs (20 vs. 18 breaths/min, p = 0.038). Other vitals and timing of crisis acknowledgment did not differ between PAICs and AOs. Nearly half of all participants (45%) identified crises at MAP <65 mmHg. Timing of crisis acknowledgment varied widely (range: 421 s).
    Conclusions: Despite overall heterogeneity in clinical performance, anesthesiologists acknowledged crises per standard definitions of hypotension. Thresholds for crisis acknowledgment did not significantly differ between PAICs and AOs, suggesting minimal effect from active care responsibility. Many indicated crises at MAP <65 mmHg or after significant deterioration, risking failure-to-rescue events. We suggest that crisis management instruction should address triggers for requesting help.
    MeSH term(s) Humans ; Anesthesiologists ; Prospective Studies ; Anesthesiology ; Respiratory Rate ; Anaphylaxis/diagnosis ; Anaphylaxis/etiology
    Language English
    Publishing date 2023-08-24
    Publishing country United States
    Document type Observational Study ; Journal Article
    ZDB-ID 1011618-7
    ISSN 1873-4529 ; 0952-8180
    ISSN (online) 1873-4529
    ISSN 0952-8180
    DOI 10.1016/j.jclinane.2023.111235
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  5. Article: Was COVID-19 a heyday for education? Lessons learned from a COVID-19 "pop-up" simulation developed overnight.

    Orgill, Britlyn D / Hao, David / Day, Celeste J M / Kardong-Edgren, Suzan / Minehart, Rebecca D

    Proceedings (Baylor University. Medical Center)

    2023  Volume 37, Issue 1, Page(s) 177–179

    Abstract: Introduction: To adjust for the COVID-19 pandemic's rapidly changing guidelines and clinical needs, educators turned to simulation to create realistic yet safe environments for drilling and innovating various care strategies. Individually, institutions ... ...

    Abstract Introduction: To adjust for the COVID-19 pandemic's rapidly changing guidelines and clinical needs, educators turned to simulation to create realistic yet safe environments for drilling and innovating various care strategies. Individually, institutions faced creating a pathway for deploying new behaviors and techniques widely across their populace.
    Methods: In response to this need, we rapidly developed an interprofessional teaching curriculum for safe intubation techniques and donning/doffing of personal protection equipment to anesthesiology clinicians and technicians. Participants were taught using Roussin's Zone 1 simulation techniques including coaching from interprofessional facilitators. Survey data were collected from participants.
    Results: Participants' confidence levels increased, with coaching and the use of simulation cited as the most useful elements of the training.
    Conclusions: We believe COVID-19 catalyzed many educational initiatives, and though teams drew their own roadmaps to create programs, sharing the learning from these endeavors may inform future similar situations. Lessons of stakeholder buy-in, use of multidisciplinary teams, and building a psychologically safe space can promote rapid uptake of new techniques and technologies.
    Language English
    Publishing date 2023-12-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2703932-8
    ISSN 1525-3252 ; 0899-8280
    ISSN (online) 1525-3252
    ISSN 0899-8280
    DOI 10.1080/08998280.2023.2276618
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  6. Article ; Online: Teaming: learning, competing, and innovating in the world of reproductive medicine.

    Minehart, Rebecca D / Su, Henry K / Petrozza, John C

    Fertility and sterility

    2021  Volume 117, Issue 1, Page(s) 10–14

    Abstract: Healthcare teams must be deliberately cultivated to reach their full potential. Shifting focus from individual performance to a team's collective competence allows for targeted and evidence-based interventions that support teamwork and improve patient ... ...

    Abstract Healthcare teams must be deliberately cultivated to reach their full potential. Shifting focus from individual performance to a team's collective competence allows for targeted and evidence-based interventions that support teamwork and improve patient outcomes. We reviewed essential concepts drawn from team science and explored the practical applications of teaming. Reproductive endocrinology and infertility healthcare providers play a pivotal role by teaching, modeling, and fostering teaming attitudes and behaviors. Through teaming, we can maximize our teams' ability to learn, innovate, compete with other teams, and thrive in today's healthcare environment.
    MeSH term(s) Clinical Competence ; Endocrinology/education ; Endocrinology/organization & administration ; Female ; Health Personnel/education ; Health Personnel/organization & administration ; Health Personnel/standards ; Humans ; Inventions/trends ; Learning ; Male ; Patient Care Team/organization & administration ; Pregnancy ; Reproductive Medicine/education ; Reproductive Medicine/organization & administration ; Reproductive Medicine/trends ; Therapies, Investigational/trends
    Language English
    Publishing date 2021-12-16
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 80133-1
    ISSN 1556-5653 ; 0015-0282
    ISSN (online) 1556-5653
    ISSN 0015-0282
    DOI 10.1016/j.fertnstert.2021.11.030
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  7. Article ; Online: Perceptions and goals of preoperative planning conversations between anesthesiology residents and attending physicians.

    Kamdar, Brinda B / Zee, Howard / Preiss, David / Navedo, Deborah D / Minehart, Rebecca D

    Journal of clinical anesthesia

    2023  Volume 87, Page(s) 111086

    Abstract: Study objective: To systematically evaluate anesthesiology resident and attending perceptions of preoperative planning conversations (POPCs) and to generate understanding for improving the educational and clinical value of this practice.: Design: ... ...

    Abstract Study objective: To systematically evaluate anesthesiology resident and attending perceptions of preoperative planning conversations (POPCs) and to generate understanding for improving the educational and clinical value of this practice.
    Design: cross-sectional study.
    Setting: two large Northeastern US academic residency training programs.
    Participants: clinically practicing anesthesiology residents and attendings.
    Interventions: An electronic survey was administered to 303 anesthesia attendings and 168 anesthesia residents across two academic institutions between June and July 2014.
    Measurements: Survey questions addressing phone call frequency and duration, clinical value, educational value and intended purpose of POPC were administered to both groups. Chi-squared tests were used to evaluate differences in responses between groups, with p < 0.05 as statistically significant.
    Main results: Responses were collected from 93 attending physicians (31%) and 80 trainee physicians (48%) for an overall response rate of 37%. 99% of residents reported paging their attendings to engage in the POPC the evening prior to all operations and 95% of trainees reported almost always receiving a call back from the attending. Trainees overwhelmingly reported attendings would believe they were unprofessional or negligent if they did not initiate a POPC (73% vs 14%, chi-square = 60.9, p < 0.001). Attendings were much more likely to view the POPC as a very important tool to discuss perioperative events (60% vs 16%, chi-square = 37.3, p < 0.001) and necessary for the majority or every case (59% vs. 31%, chi-square = 13.5, p < 0.001). The majority of attendings and trainees did not find the POPC to be a very important educational tool in terms of assessing trainee knowledge base (14% vs. 6%, chi-square = 2.76, p = 0.097), discussing teaching opportunities (26% vs. 9%, chi-square = 8.5, p = 0.004), or establishing rapport (24% vs. 7% trainees, chi-square = 8.3, p = 0.004).
    Conclusions: Significant discrepancies exist between how anesthesia attendings and residents perceive the purpose of the POPC, with trainees less likely to view the POPC as having clinical value and neither group perceiving the conversation as a very useful educational tool. The results highlight the need to reexamine the value of the daily POPC as a deliberate educational practice to meet expectations of both trainees and attendings.
    MeSH term(s) Humans ; Anesthesiology ; Cross-Sectional Studies ; Goals ; Internship and Residency ; Physicians ; Clinical Competence
    Language English
    Publishing date 2023-03-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1011618-7
    ISSN 1873-4529 ; 0952-8180
    ISSN (online) 1873-4529
    ISSN 0952-8180
    DOI 10.1016/j.jclinane.2023.111086
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  8. Article: Preface.

    Pian-Smith, May C M / Minehart, Rebecca D

    Anesthesiology clinics

    2021  Volume 39, Issue 4, Page(s) xv–xvi

    Language English
    Publishing date 2021-11-14
    Publishing country United States
    Document type Editorial
    ZDB-ID 2228899-5
    ISSN 2210-3538 ; 1932-2275 ; 0889-8537
    ISSN (online) 2210-3538
    ISSN 1932-2275 ; 0889-8537
    DOI 10.1016/j.anclin.2021.09.001
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  9. Article ; Online: Protecting healthcare providers from COVID-19 through a large simulation training programme.

    Buléon, Clément / Minehart, Rebecca D / Fischer, Marc-Olivier

    British journal of anaesthesia

    2020  Volume 125, Issue 5, Page(s) e418–e420

    MeSH term(s) Betacoronavirus ; COVID-19 ; Coronavirus Infections/prevention & control ; France ; Health Personnel/education ; Humans ; Inservice Training/methods ; Pandemics/prevention & control ; Pneumonia, Viral/prevention & control ; SARS-CoV-2 ; Simulation Training/methods
    Keywords covid19
    Language English
    Publishing date 2020-08-05
    Publishing country England
    Document type Letter
    ZDB-ID 80074-0
    ISSN 1471-6771 ; 0007-0912
    ISSN (online) 1471-6771
    ISSN 0007-0912
    DOI 10.1016/j.bja.2020.07.044
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  10. Article: Racial Differences in Pregnancy-Related Morbidity and Mortality.

    Minehart, Rebecca D / Jackson, Jaleesa / Daly, Jaime

    Anesthesiology clinics

    2020  Volume 38, Issue 2, Page(s) 279–296

    Abstract: Racism in the United States has deep roots that affect maternal health, particularly through pervasive inequalities among black women compared with white. Anesthesiologists are optimally positioned to maintain vigilance for these disparities in maternal ... ...

    Abstract Racism in the United States has deep roots that affect maternal health, particularly through pervasive inequalities among black women compared with white. Anesthesiologists are optimally positioned to maintain vigilance for these disparities in maternal care, and to intervene with their unique acute critical care skills and knowledge. As leaders in patient safety, anesthesiologists should drive hospitals and practices to develop and implement national bundles for patient safety, as well as using team-based training practices designed to improve hospitals that care for racially diverse mothers.
    MeSH term(s) Adult ; African Americans ; Anesthesiologists ; European Continental Ancestry Group ; Female ; Healthcare Disparities/ethnology ; Humans ; Maternal Mortality/ethnology ; Morbidity ; Patient Safety ; Physician's Role ; Pregnancy ; Prenatal Care ; Racism ; Risk Factors
    Language English
    Publishing date 2020-04-26
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2228899-5
    ISSN 2210-3538 ; 1932-2275 ; 0889-8537
    ISSN (online) 2210-3538
    ISSN 1932-2275 ; 0889-8537
    DOI 10.1016/j.anclin.2020.01.006
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