title: Practice improvements based on participation in simulation for the maintenance of certification in anesthesiology program.
abstract: BACKGROUND
  This study describes anesthesiologists' practice improvements undertaken during the first 3 yr of simulation activities for the Maintenance of Certification in Anesthesiology Program.
  
  
  METHODS
  A stratified sampling of 3 yr (2010-2012) of participants' practice improvement plans was coded, categorized, and analyzed.
  
  
  RESULTS
  Using the sampling scheme, 634 of 1,275 participants in Maintenance of Certification in Anesthesiology Program simulation courses were evaluated from the following practice settings: 41% (262) academic, 54% (339) community, and 5% (33) military/other. A total of 1,982 plans were analyzed for completion, target audience, and topic. On follow-up, 79% (1,558) were fully completed, 16% (310) were partially completed, and 6% (114) were not completed within the 90-day reporting period. Plans targeted the reporting individual (89% of plans) and others (78% of plans): anesthesia providers (50%), non-anesthesia physicians (16%), and non-anesthesia non-physician providers (26%). From the plans, 2,453 improvements were categorized as work environment or systems changes (33% of improvements), teamwork skills (30%), personal knowledge (29%), handoff (4%), procedural skills (3%), or patient communication (1%). The median word count was 63 (interquartile range, 30 to 126) for each participant's combined plans and 147 (interquartile range, 52 to 257) for improvement follow-up reports.
  
  
  CONCLUSIONS
  After making a commitment to change, 94% of anesthesiologists participating in a Maintenance of Certification in Anesthesiology Program simulation course successfully implemented some or all of their planned practice improvements. This compares favorably to rates in other studies. Simulation experiences stimulate active learning and motivate personal and collaborative practice improvement changes. Further evaluation will assess the impact of the improvements and further refine the program.
authors.affiliation: From the Department of Anesthesiology, David Geffen School of Medicine at University of California, Los Angeles (UCLA), and UCLA Simulation Center, Los Angeles, California (R.H.S., Y.M.H.); Department of Anesthesiology, Simulation Center Cooper Medical School of Rowan University, Cooper University Hospital, Camden, New Jersey (A.R.B.); Center for Immersive and Simulation-based Learning, Stanford University School of Medicine; Anesthesiology and Perioperative Care Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, California (D.M.G.); and Center for Medical Simulation, Boston, Massachusetts, and Harvard Medical School and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts (J.B.C.).
authors.forename: Randolph H
authors.initials: RH
authors.lastname: Steadman
authors.forename: Amanda R
authors.initials: AR
authors.lastname: Burden
authors.forename: Yue Ming
authors.initials: YM
authors.lastname: Huang
authors.forename: David M
authors.initials: DM
authors.lastname: Gaba
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Cooper
mesh_terms: D000776:Anesthesiology / Q000193:education* / Q000592:standards*; D002568:Certification; D002983:Clinical Competence / Q000592:standards*; D004282:Documentation; D006801:Humans; D008348:Manikins; D016544:Patient Simulation; D058996:Quality Improvement / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013664:Teaching Materials