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American Board of Anesthesiology Examination Versus Simulators

Section Editor(s): Shafer, Steven L.Aldrete, J Antonio MD, MS

doi: 10.1213/
Letters to the Editor: Letters & Announcements

Department of Anesthesiology; University of Alabama at Birmingham; Aldrete Pain Care Center, Inc.; Birmingham, Alabama;

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To the Editor:

Rose and Burkle (1) analyzed some of the overlapping aims of graduate medical education as defined by the Accreditation Council for Graduate Medical Education competencies and the American Board of Anesthesiology (ABA). However, is not the most important question “Can the candidate safely administer anesthesia?” If the answer to this question is “yes,” then where are the data showing that performance on a written test correlates with ability to safely administer anesthesia?

I assert, without evidence, that by observing residents administering anesthesia I can distinguish residents who are competent from those who are not. Why not focus our professional certification on safety by including in ABA evaluations an examination session using a simulator? For over 35 yr (2,3) simulators have been used to train residents in anesthesia. Simulator sophistication has reached most of the subspecialties, such as pediatrics, pain medicine, cardiovascular monitoring, airway management, anesthesia for trauma, and regional anesthesia. To better determine the efficiency and competency of an anesthesiologist, the ABA should consider developing a test with simulators. Indeed, our specialty could score another “safety first” point by using truly objective methodology to determine the ability of examinees to apply their theoretical knowledge to resolve complicated situations found in the daily practice of anesthesia.

No one would accept certified or recertified pilots who passed only written or computer tests. Why not shoot for the sky?

J. Antonio Aldrete, MD, MS

Department of Anesthesiology

University of Alabama at Birmingham

Aldrete Pain Care Center, Inc.

Birmingham, Alabama

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1. Rose SH, Burkle CM. Accreditation Council for Graduate Medical Education competencies and the American Board of Anesthesiology Clinical Competence Committee. Anesth Analg 2006;102:212–6.
2. Denson JS, Abrahamson S. A computer-controlled patient simulator. JAMA 1969; 208:504–8.
3. Good ML, Gravenstein JS. Anesthesia simulators and training devices. Int Anesth Clin 1989;27:161.
© 2006 International Anesthesia Research Society