Anesthesiology & Pain Medicine >> Education >> Residency Program Goals and Objectives

Residency Training Program
Goals and Objectives

The Educational Mission of the Department of Anesthesiology & Pain Medicine

Mission Statement

The educational programs at the Department of Anesthesiology and Pain Medicine teach trainee physicians the knowledge, skills and professionalism required for clinical excellence; promote compassionate patient care; inspire a sense of enquiry and life-long learning; and develop leaders in anesthesiology, pain medicine, and critical care for the 21st century.

Rotational Goals and Objectives

Goals and objectives are defined for all the training rotations that residents undertake during their residency training in anesthesiology, critical care and pain medicine. They are graded depending on the training year and the resident’s level of experience.

Goals and objectives define the knowledge, psychomotor and behavioral skills and attitudes that residents should develop during the training period. They also define the expectations the resident needs to meet to successfully complete each stage of the training in anesthesiology, critical care and pain medicine.

Photo of Dr. Calvin Eng
Dr. Calvin Eng adjusts a syringe pump during a craniotomy for tumor resection under total intravenous anesthesia

The Four Stages of Learning &
The Three Domains of Education

The education and development of an anesthesiologist in training, like any learning experience, involves four stages and three domains of learning.

The four stages of learning are as follows:

Unconscious Incompetence
At this is a stage the learner is unaware of his/her inability to complete tasks which might at first appear exceedingly simple. It is important to recognize this stage early in the training experience to avoid becoming discouraged if early attempts to complete tasks are unsuccessful.
Conscious Incompetence
At this stage the learner realizes he/she is not easily able to perform many of tasks expected of them. Residents progress rapidly through this phase, and it is important at this stage not to dwell on failures but continue to practice and listen to advice from senior faculty.
Conscious Competence
This is the most rewarding phase of learning as residents increase in confidence and they develop and fine tune their skills.
Unconscious Competence
This phase is characterized by performing and being successful in tasks without actually thinking about them. It is important to regularly look for this phase in training o the learner can appreciate just how far he or she has progressed.

At every stage of the learning process residents are supervised and encouraged by their anesthesiology faculty and staff members. Residents should accept they may not get things right the first time. It is important that residents reflect on their performance and seek feedback and guidance from their faculty on how to improve and eventually succeed.

The three domains of learning are as follows:

Cognitive Knowledge
Knowledge and processing of information, "how you think."
Psychomotor Skill
Technical procedures requiring hand-eye coordination.
Affective Behavior
Behaviors and attitudes. Specifically, professionalism and your approach to life-long learning.

Resident should keep the three domains and four stages of learning in mind as they read through the goals and objectives. They will help residents get the most out of their education and training.

Competency and the ACGME Competencies

Professional competence has been defined as "the habitual & judicious use of communication, knowledge, technical skill, evidence-based decision-making, emotion, values and reflection to improve the health of the individual patient and the community" (Epstein 1992)

In recent years there has been a great deal of work devoted to the question of what makes a competent doctor. The ACGME, which oversees all residency training, has defined six General Competencies for all residents.

All residents are required to receive training in these competencies as they relates to their specialties, and the residency program is required to evaluate residents in all of the six competencies.

The six general competencies are:

  • Patient Care
  • Medical Knowledge
  • Practice-based Learning and Improvement
  • Interpersonal Communication Skills
  • Professionalism
  • Systems-based Practice

The goals and objectives for each resident rotation are organized according to these competencies to help residents understand how the competencies fit into their day to day practice and what actions are required to receive successful evaluations at the end of each rotation and during the residency program as a whole.

Graduated Responsibility

Anesthesiology residency training is a graduated process. At each stage during the three CA year residents are presented with new and unique challenges. These are designed to help residents develop their skills in a graded way and ultimately allow residents to become independent practitioners capable of performing all aspects of anesthesia care. Residents are supervised at all times during their training and should always summon assistance if needed.

photo of child measuring milestones

Educational Milestones

In 2014 all anesthesiology programs transitioned to the ACGME Next Accreditation System (NAS). This new system provides a structured approach to residency training with an emphasis on patient safety. Full details are available on the ACGME website.

Educational Milestones are key evaluation tools for the NAS. These provide residents with a variety of opportunities for learning and self-reflection during their training. At University of Washington all resident evaluations are formatted in line with the anesthesiology milestones.