KEY POINTS

1. Education is an all-encompassing process (not merely a specific activity) resulting in a change in behavior on the part of the student/learner. The focus of education is the learner, not the teacher. It is the student who is educated by interacting with an environment that provides experience or experiences. Education is a change in behavior based on experiences.
2. Adult learners learn anesthesiology. Adult learners are those with strong motivation to participate in a set of experiences to learn a specific discipline. The discipline they want to learn is one that they are interested in and/or need to know. Adult learners participate in life-centered situational learning in the area or areas in which relevance is most likely.
   Adult learners enter the learning activity with a wealth of previous experiences and view the current education in light of their background. Adult learners can capitalize on this previous learning; however, the previous learning may color how the current learning takes place.
   

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   Adult learners are self-directed and initiate their own activities. Adult learning is goal oriented toward relevant life-centered needs. An adult learner tends to pick and choose some, not necessarily all of the educational activities available.
   Inherent differences among people tend to increase with aging. Adult education must provide for differences in style, time, place, and pace of learning among adult learners. The time factor for learning is especially crucial for adults. Adults perceive that time passes more rapidly; that is, there is less time available to learn—or to do anything for that matter. With time perceived to be in short supply, adult learners tend to be selective in their learning to use what time they have more efficiently.
3. In 2002, there were 4578 resident anesthesiologists in 132 accredited American core anesthesiology residency programs and 309 subspecialty residents in 186 accredited American subspecialty anesthesiology programs.
4. Silber and colleagues,^[19] in their study of almost 6000 patients undergoing prostate or gallbladder surgery in multiple hospitals, demonstrated that patient recovery or "rescue" from an adverse event correlated with the proportion of board-certified anesthesiologists in the hospital.
5. The ACGME has defined six educational areas for which students must demonstrate competencies:
1. Patient Care—Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.
2. Medical Knowledge—Residents must demonstrate knowledge about established and evolving biomedical, clinical, and cognate (e.g., epidemiologic and social-behavioral) sciences and the application of this knowledge to patient care.
3. Practice-Based Learning and Improvement—Residents must be able to investigate and evaluate their patient care practices, appraise and assimilate scientific evidence, and improve their patient care practices.
4. Interpersonal and Communication Skills—Residents must be able to demonstrate interpersonal and communication skills that result in effective information exchange and teaming with patients, their patients' families, and professional associates.
5. Professionalism—Residents must demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population.
6. Systems-Based Practice—Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care and an ability to effectively call on system resources to provide care that is of optimal value. ^*
6. Full-time anesthesiology faculty positions in U.S. medical schools in 2002–2003 numbered 5073.^[25] Most (94.4%) of these budgeted positions were filled.^[25] Anesthesiologists represent 5.6% of the clinical teachers and 4.6% of all American medical school teaching faculty. ^[25] The 5073 anesthesia faculty members in medical schools bear the major responsibility for teaching some or all of the 66,677 enrolled undergraduate medical students, the 4887 graduate trainees in anesthesiology residency training programs, and many of the approximately 98,258 physician house-staff trainees. ^{[10] [25] [26]}
7. Effective clinical teachers who are able to succeed at the bedside teaching encounter display specific actions noted by their students and themselves.^[29] These actions include
1. Allocating time for teaching
2. Creating a teaching/learning environment of trust and concern
3. Demonstrating clinical credibility
4. An initial orientation
5. A final evaluation
6. Learners being able to present a case
7. Teachers managing the case presentation
8. Didactic sessions being used to enhance clinical case material
9. Teaching taking place at the bedside so that students can learn physician-patient relationships
10. Teachers and students discussing psychosocial issues
11. Attention being paid to transferring the teaching responsibility
8. Teaching content requires attention to increasingly complex cognitive functions. As described by Bloom,^[33] teaching/learning in the cognitive domain for any topic addresses the following:
1. Knowledge—recall
2. Comprehension—understanding
3. Application—use of abstractions
4. Analysis—break down; seeing the relationship of parts
5. Synthesis—put together; creating a new entity
6. Evaluation—judgment of value
9. A systematic methodology to develop a psychomotor skill lesson includes the following steps:
1. Analyze and separate the skill into its component parts and determine which aspects of the skill are most difficult to perform.
2. Provide students with a model of the skill, effectively demonstrated in its entirety, that they are expected to perform.
3. Make provisions for students to practice until the expected behavior is mastered.
4. Provide adequate supervision and an evaluation of the final performance.