Teaching and Operating Room Efficiency

In Response: We appreciate the kind comments of Dr. Pivalizza et al. For these studies, the primary anesthesiology provider of the anesthesia care team was recorded in data collection (1,2). Since medical students and others are “inserted” into the anesthesia care team during their rotation, we did not stratify the data by medical student, paramedical staff, etc. As we reported in the Discussion, teaching can occur in other parts of the perioperative period, such as maintenance of anesthesia or postanesthetic debriefing, for example. In the current economic climate, this study strongly suggests that other educational paradigms for resident teaching may be required. These include more extensive use of computerized instruction and simulators. Alternatively, faculty can prioritize resident instruction for a given case, such that the necessary aspects of important principles of induction are emphasized (“the teachable moment”) during the induction phase and other aspects of patient care are developed at other time points during the perioperative period. Elizabeth A. Davis, RCDS Paul Barash, MD Department of Anesthesiology Yale University School of Medicine and Yale-New Haven Hospital New Haven, CT [email protected]