Today we're speaking with Dr. Rebecca Hong, from the University of Michigan. Dr. Hong, can you tell us a little bit about your practice? >> Sure, I'm an anesthesiologist. I work at Mott Children's Hospital. So most of my practice involves pediatric patients. I work with residents from early on in their training clear through the fellows. >> Fantastic. So we've been learning about the BID model and we know it's successful in a number of contexts. But it would be great to hear how you think it could be applied to your area, in anesthesiology. >> Sure, I think the briefing is important and it's something that could very easily be done when the residents call the night before to staff the cases for the next day. Make it a practice to ask the residents if there's anything in particular that they would like to talk about or learn about the next day. Often I get the response of, I'm not real sure, I don't know. But I think with this model it's important for me to be more deliberate in getting a little bit more feedback from their end about where they actually are in the learning process and what we can focus on for the next day's case. >> I know it's really difficult when you're in the middle of a case to try to think about intraoperative teaching. I think that many of us as surgeons hear anesthesiologists teaching a lot and we envy that at times. Do you think this is realistic to try to teach in the middle of a case? >> I do think so. I think with anesthesiology procedures, things like Laryngoscopy, IV placement are very short, it's difficult to teach during that. But it's usually after those short procedures are over there's plenty of time to reflect on what has happened. >> And that reflection brings up the thought about debriefing. Do you anticipate any kinds of barriers to debriefing? >> I think debriefing with a typical anesthesiologist workflow is actually difficult. It requires being a little more intentional about doing it. Because I feel like it's important to wait until after the case has completely finished and the child has emerged from the anesthesia to see entirely how the case went in order to know exactly what direction to take the debrief in. And then it can be challenging to get that accomplished in the short period of time that we have in-between cases when there's time pressure to get the next case started. >> Any thoughts about how you could interweave some debriefing throughout the procedure and then have a summation at the end? >> Sure, I think the key components of any anesthetic is the induction and the maintenance phase and the emergence. And certainly reasonable to talk about and debrief on the induction and maintenance phrase while the surgeon is, for example, closing skin or finishing up their part of the operation. And then debriefing about the emergence part can usually happen after the pack you sign out. I think probably what would really make the most difference is just setting the expectation up front with the learner in the beginning part of the day to expect a debrief to happen later on. And then when it only takes a few minutes and they're expecting it, it's probably a little bit easier to work it in to the workflow. >> I think that's fantastic. Dr Hong, thank you very much for being with us today. >> Welcome.
