Improving Resident Orientation to Anesthesiology Subspecialties Using a Structured “Passport”

Background. On an initial pediatric, cardiothoracic, or obstetric anesthesiology rotation, a resident faces new knowledge and procedural expectations. Lack of guidance to direct learning may lead residents to feel unprepared. The optimal way to prepare residents is unknown. This initiative included the introduction of a structured “passport” for each subspecialty specifying the knowledge and procedural goals of an introductory rotation. This intervention aimed to improve resident and attending perceptions of resident readiness on these anesthesiology subspecialty rotations, as measured using pre- and post-initiative surveys of residents and attendings. Methods. This initiative occurred at a large anesthesiology residency with 53 residents in 2022-2023. “Passports" containing checklists of concepts and skills for each resident to review with attending anesthesiologists over the first 4-week period in each of these subspecialty rotations were provided. Perceptions of clinical readiness were assessed using pre-intervention and post-intervention surveys sent to residents and attending anesthesiologists. Results. The obstetric anesthesiology passport was associated with improvements in resident and attending assessments of clinical readiness, while the use of the pediatric anesthesiology passport was associated with improvements in attending assessments primarily. The use of the cardiothoracic anesthesiology passport was associated with improvements in resident assessments primarily. Effect sizes for most categories were moderate to large. No barriers to implementation were noted. Conclusion. The introduction of a structured passport during residents’ initial subspecialty rotations resulted in moderate to large improvements in resident and attending perceptions of clinical readiness across multiple domains. This initiative can easily be applied to other anesthesiology residencies.