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PubMed · 10192074

Why do we need Royal Colleges?

A K Adams
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Abstract

Today's Royal Colleges can be traced to the guilds that arose during the 13th and 14th centuries. They fulfil similar roles: to maintain the highest standards of practice, professional integrity and self-regulation. This paper traces the development of the Royal Colleges, together with the emergence of specialisation within medicine, with particular reference to anaesthesia as a modern specialty. It considers whether these functions are still appropriate for the rapidly changing practice of medicine today. The colleges have unique strengths, but they also have weaknesses and must be prepared to counter threats to their professional function.

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AnesthesiologyForecastingHistory, 15th CenturyHistory, 17th CenturyHistory, 18th CenturyHistory, 19th CenturyHistory, 20th CenturyHistory, MedievalHumansSocieties, MedicalUnited KingdomHistorical ArticleJournal Article

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A K Adams. Why do we need Royal Colleges?. https://pubmed.ncbi.nlm.nih.gov/10192074/

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PubMed2007

Perception of training needs and opportunities in advanced airway skills: a survey of British and Irish trainees.

BACKGROUND AND OBJECTIVE: We surveyed delegates at the Group of Anaesthetists in Training (UK) meeting to investigate evidence of a training-gap (number of fibreoptic intubations believed to bestow competence vs. number actually performed). METHODS: Questionnaires were distributed to and collected from delegates in person. Questions covered six areas, including experience of fibreoptic intubation and cricothyrotomy, fibreoptic intubation as a specialist skill and ethical issues. RESULTS: We received 221 replies (76%). All trainees believed competence to be achievable with 10 intubations (interquartile range (IQR) 10-20); the median number performed was 2 (IQR 0-4). This was statistically significant for the groups' senior house officers, 1st and 2nd year registrars and 3rd and 4th year registrars; P < 0.0001. Many final year trainees (12/20, 60%) also failed to achieve their competency target. Few trainees had seen or performed any cricothyrotomies (medians 0, IQRs 0-1 and 0-0). Most (195/208, 94%) believed that fibreoptic intubation was a core skill and 199/212 (94%) believed that all should be competent by completion of training. Ten percent (n = 208) felt it unethical to perform an awake training intubation with full consent and 10% believed it acceptable without explanation. Most (82.7%) would fibreoptically intubate an asleep patient (requiring intubation) without consent. CONCLUSION: Trainees reported a gap between their perception of competence and achievement in awake fibreoptic intubation. Simple and complex simulations and structured training programmes may help. Anaesthetists must address the ethics of clinical training in advanced airway management.

Anesthesiology↗