Abstract
BACKGROUND: Anesthesiologic activity in the delivery room environment implies the specifics of a 200% lethality, which describes that emergency situations can affect mother and child. A circumstance that impressively underlines the need for special care in employee training and selection. The training situation in the delivery room is characterized by several difficulties. Technical procedures are often performed on the awake patient, who is herself in an exciting situation during childbirth. A detailed description of the necessary competences in this working environment does not exist at the present. The present study aims to describe the further education situation in anesthesiology. The results can represent the first step of a curriculum development according to the concept of Kern et al. in the sense of a needs assessment. MATERIAL AND METHODS: In a multicenter observational study, doctors in further training (AiW) and consultants (FÄ) were asked about methods of familiarization, feedback, activities taken on and the need for a curriculum. The level of supervision and confidence in action during procedures was also elicited. Participants were contacted via the membership database of the German Society of Anesthesia and Intensive Care and could answer the 11-item questionnaire online. RESULTS: A total of 495 questionnaires (329 FÄ; 166 AiW;) were completed. The FÄ and AiW gave different information on the conduct of exit interviews (59.6% vs. 10%) and curriculum support (76.3% vs.17.5%). Independent of the year of training, AiWs perform cesarean sections under on-demand (reactive) supervision. Peridural anesthesia (PDA) is the least frequently performed procedure in the context of the familiarization situation with obstetric anesthesia. The groups have a different confidence of security in the successful implementation of procedures, when AiW are proceeding without direct supervision (FÄ = MD 61; AiW = MD 77; p < 0.001; scale 0 = unsecure-100 = very secure). Practical and technical support is mostly provided immediately by FÄ (> MW 91; scale 0 = never-100 = immediately). Individual values deviate significantly from the average values (outliers). Both groups rate the usefulness or value of describing learning objectives and the availability of a curriculum as high. DISCUSSION: The support of familiarization and continuing support is partly answered differently by consultants and doctors in further training. Individual procedures that are rarely performed, such as administration of a PDA, require special attention in the future. Curricula with workplace-based assessments could provide feedback and assurance to increase confidence in the successful implementation of procedures by AiW. The AiW usually receive immediate professional support. Individual institutions do not seem to have any concepts here and must rethink their processes. This fact is particularly important against the background of the medicolegal significance of the subject. The description of learning objectives and curriculum development is desired both by FÄ and AiW.