Teaching monitoring skills

Introduction Most medical schools and residency programs do not have a formalized training and assessment program dedicated to the acquisition of skills and knowledge needed for monitoring the perioperative patient. This is understandable, as the current model of medical education was developed during the early 20th century, when the act of monitoring during a procedure meant a very different enterprise from the current state of the art in anesthesiology. Typically, information related to monitor output was first learned piecemeal throughout medical school, and only when it was necessary to demonstrate changes in patient physiology related to a drug or disease process. It was rarely taught as a stand-alone topic, even at the graduate medical education (GME) level. Although the Accreditation Council for Graduate Medical Education (ACGME) defines the scope of practice for anesthesiology to include “monitoring and maintenance of normal physiology during the perioperative period” and mandates that anesthesiology residents have “significant experience with central vein and pulmonary artery catheter placement and the use of transesophageal echocardiography and evoked potentials,” a standardized curriculum and a standardized assessment for monitor training do not currently exist. Physicians in training learn monitoring skills in the same way they learn other procedures, by “seeing, doing, and teaching.”