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Innovation in sedation and analgesia training

Teng, Wei-Nunga; Su, Bai-Chuanb,c; Cheng, Hung-Weia,b

Current Opinion in Anesthesiology: August 2019 - Volume 32 - Issue 4 - p 472–479
doi: 10.1097/ACO.0000000000000757
DRUGS IN ANESTHESIA: Edited by Ken B. Johnson

Purpose of review We reviewed evidence of recent innovations in sedation education and discuss experiences with sedation training in Taiwan.

Recent findings Current Status of Sedation Training: Didactic training and supervised clinical mentoring are common methods of sedation training. Although training course designed by professional societies to meet individual hospital credentialing requirements, the course content and training expectations vary and are likely inadequate to non-anesthesiologist sedation practitioners. Less Common Forms of Sedation Training: These include screen-based simulation, high-fidelity manikin-based simulation. Screen-based simulation sedation training is popular, convenient, and relatively inexpensive. Although there are numerous courses available, course content has not been standardized. High-fidelity simulation has been accepted to improve knowledge, self-confidence, awareness of emergency, crisis resource management, and teamwork, but it is costly, time intensive, and requires expertise in using simulation equipment. Although screen-based training is attractive and convenient, there is no evidence to suggest that it can replace high-fidelity simulation. Another recently developed education modality is virtual reality simulation. It has gained recent popularity as an immersive approach to medical training, but minimal content has been developed for sedation training. Beyond training, several other potential innovations may improve sedation effectiveness and patient safety. These include adherence to practice guidelines established by professional organizations, utilization of a pre-procedure sedation checklist, interpreting capnography, and implementation of real-time bedside drug displays that provide predictions of concentrations and their associated effects.

Summary Effective sedation education and training, especially for nonanesthesiologists, is essential to improve patient safety for procedural sedation. Several innovative approaches have been proposed and are relatively early in their development and implementation. Further studies designed to assess the impact of these new training modalities on patient safety and outcomes are warranted.

aDepartment of Anesthesiology, Taipei Veterans General Hospital

bSedation and Anesthesia Committee, Taiwan Society of Anesthesiologists

cStardust Sedation and Analgesia Group, Taipei, Taiwan ROC

Correspondence to Hung-Wei Cheng, MD, Department of Anesthesiology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Taipei, Taiwan ROC. Tel: +886 2 28757549; fax: +886 2 28751597; e-mail:

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