A proposed method for the measurement of anesthetist care variability

Objective. Some critical events in anesthesiology occur as seemingly preven table misadventures, their exact origins indeterminable. Inexperienced anes thetists, anesthesia machine malfunctions, lack of vigilance and human erro r inevitably initiate some incidents [1]. Anesthesia training improves reco gnition and decision-making. Avoiding crisis initiation and amelioration of those that do occur is one role of the consultant anesthesiologist [2]. Sa fe patient care requires medical and procedural knowledge, technical expert ise, and control of resources in a complex milieu [3]. Anesthesia simulator s are clinical laboratories where anesthetists can sharpen both cognitive a nd manual skills [4, 5, 13]. Dynamic scenarios allow opportunities for anes thetists to explore and experience crises as they develop and apply their k nowledge while attempting to manage these events [6]. Simulator-based scena rios are reproducible and large amounts of useful data can be collected and saved [7]. The authors hypothesize these data can be utilized to compare p erformance of anesthetists and to measure improvement of individual anesthe tists over time. Methods. We have designed "Stable Anesthesia," a prototypi c scenario to test anesthetists' capabilities under the stress of performan ce guidelines. Three subjects performed anesthesia using the simulator and this protocol. Data from the simulator were archived by the system and anal yzed by the authors. Results.A simple mathematical analysis gave good separ ation of data from three subjects of different training level. Conclusions. It is suggested that the use of the techniques mentioned here may be of va lue in the development of a standardized testing protocol for anesthetists.