title: Emergency Medicine resident anesthesia training in a private vs. academic setting.
abstract: BACKGROUND
  Airway management is an essential part of any Emergency Medicine (EM) training program. Academic centers typically provide training to many learners at various training levels in a number of medical specialties during anesthesiology rotations. This potentially creates competition for intubation procedures that may negatively impact individual experiences.
  
  
  OBJECTIVE
  We hypothesized that residents would report higher numbers of intubations and improved educational value in a private practice, rather than an academic, anesthesiology rotation.
  
  
  METHODS
  EM residents' anesthesiology training was evaluated pre and post a change in training setting from an academic institution to a private practice institution. Outcome measures included the number of self-reported intubations, resident ratings of the rotation, and the number of positive comments. Residents' evaluation was measured with: a 14-item evaluation; subjective comments, which two blinded reviewers rated as positive, negative, or neutral; and transcripts from structured interviews to identify themes related to training settings.
  
  
  RESULTS
  The number of intubations increased significantly in the private practice setting (4.6 intubations/day vs. 1.5 intubations/day, p < 0.001). Resident evaluations improved significantly with the private practice experience (mean scores of 3.83 vs. 2.23, p-values <0.05). Residents' impressions were also significantly higher for the private practice setting with respect to increased educational value, greater use of adjunct airway devices, and directed teaching.
  
  
  CONCLUSIONS
  Number of intubations performed and residents' rating of the educational value were more favorable for a private practice anesthesiology rotation. Alternative settings may provide benefit for training in areas that have competition among trainees.
authors.affiliation: Department of Surgery, Division of Emergency Medicine, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Megan L
authors.initials: ML
authors.lastname: Fix
authors.forename: Michael S
authors.initials: MS
authors.lastname: Enslow
authors.forename: Jay F
authors.initials: JF
authors.lastname: Blankenship
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Horne
authors.forename: Susan K
authors.initials: SK
authors.lastname: Stroud
authors.forename: Troy E
authors.initials: TE
authors.lastname: Madsen
authors.forename: Erik D
authors.initials: ED
authors.lastname: Barton
authors.forename: Virgil
authors.initials: V
authors.lastname: Davis
mesh_terms: D058109:Airway Management; D000776:Anesthesiology / Q000193:education*; D002983:Clinical Competence; D004635:Emergency Medicine / Q000193:education*; D006785:Hospitals, University; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration* / Q000592:standards; D011331:Private Practice; D013663:Teaching