Research Overview

I am the Principal Investigator of a research study, Assessing the Performance of First Year Anesthesia Residents to Ensure Basic Competence, which has been funded by a grant from the Harvard School of Medicine's Department of Anaesthesia, the Anesthesia Patient Safety Foundation and The Cathedral Fund. The long-term goal of this project is to have an effective, objective, credible, ongoing process for evaluation of anesthesia residents' clinical competencies ensuring that no resident graduates from any program not meeting the levels of performance that are sufficient to ensure an acceptable level of patient safety. The research team is utilizing medical simulation to evaluate residents on performance; the program will attempt to identify anesthesia residents in need of remediation early in their training programs. We have created a set of standards and criteria to test the competency of Harvard-affiliated anesthesia residents and teach them to practice safer medicine, reducing medical mistakes as well as patient complication and death. We foresee developing standards and criteria that can be adapted to each medical specialty enhancing patient safety on a large scale; we believe this education will increase overall patient safety among anesthesia residents nationwide.

Education

Medical School

University of Pennsylvania School of Medicine
1988 Philadelphia PA

Internship

Pediatrics University of Washington School of Medicine/Children’s Hospital and Regional Medical Center
Seattle WA

Fellowship

Adult and Pediatric Cardiac Anesthesia Massachusetts General Hospital/Harvard Medical School
Boston MA

Fellowship

Pediatric Cardiac and General Pediatric Anesthesia Tufts-New England Medical Center/ Boston Floating Hospital for Infants and Children
Boston MA

Publications

  1. "You Look Young! Are You a Doctor?" A Qualitative Content Analysis of Anesthesiology Resident Responses to Ageism in Clinical Encounters. Anesthesiology. 2023 Nov 01; 139(5):667-674. View Abstract
  2. Measuring deliberate reflection in residents: validation and psychometric properties of a measurement tool. BMC Med Educ. 2023 Aug 25; 23(1):606. View Abstract
  3. Characterization of Reflective Capacity of Anesthesiology Trainees in an Irish Tertiary Referral Teaching Hospital. J Educ Perioper Med. 2022 Jan-Mar; 24(1):E678. View Abstract
  4. Compassionate and Clinical Behavior of Residents in a Simulated Informed Consent Encounter. Anesthesiology. 2020 01; 132(1):159-169. View Abstract
  5. Applied reflective practice in medicine and anaesthesiology. Br J Anaesth. 2019 05; 122(5):536-541. View Abstract
  6. Simulation-based Assessment to Reliably Identify Key Resident Performance Attributes. Anesthesiology. 2018 04; 128(4):821-831. View Abstract
  7. Institutional Policy Changes to Prevent Cardiac Toxicity Associated With Bupivacaine Penile Blockade in Infants. A A Case Rep. 2016 Aug 01; 7(3):71-5. View Abstract
  8. Creation of an integrated outcome database for pediatric anesthesia. Paediatr Anaesth. 2016 Apr; 26(4):345-55. View Abstract
  9. Simulation-based assessment to identify critical gaps in safe anesthesia resident performance. Anesthesiology. 2014 Jan; 120(1):129-41. View Abstract
  10. Differences in safety climate among hospital anesthesia departments and the effect of a realistic simulation-based training program. Anesth Analg. 2008 Feb; 106(2):574-84, table of contents. View Abstract
  11. Crew resource management and team training. Anesthesiol Clin. 2007 Jun; 25(2):283-300. View Abstract
  12. A method for measuring the effectiveness of simulation-based team training for improving communication skills. Anesth Analg. 2005 May; 100(5):1375-1380. View Abstract
  13. Teaching emergency airway management using medical simulation: a pilot program. Laryngoscope. 2005 Mar; 115(3):495-500. View Abstract
  14. Instructor Qualification Guidelines for Crisis Resource Management Training in a Health Care Simulation Organization. American Society of Anesthesiologists Annual Meeting; Las Vegas, Nevada. 2004. View Abstract
  15. Discharge Guidelines for Special Procedures/Cases. Clinical Practice Guideline. 2004. View Abstract
  16. Guidelines for Obtaining Crisis Resource Management Instructor Certification (Guidelines for Crisis Resource Management Instructor Certification for all CRICO insured hospitals). 2004. View Abstract
  17. Discharge Guidelines for Ambulatory Surgery Patients. Clinical Practice Guideline. 2004. View Abstract
  18. "Chronic Upper Airway Obstruction And Cardiac Dysfunction: Anatomy, Pathophysiology And Anesthetic Implications". Pediatric Anesthesia. 2004; (14):75-83. View Abstract
  19. Chronic upper airway obstruction and cardiac dysfunction: anatomy, pathophysiology and anesthetic implications. Paediatr Anaesth. 2004 Jan; 14(1):75-83. View Abstract
  20. Crisis resource management training for an anaesthesia faculty: a new approach to continuing education. Med Educ. 2004 Jan; 38(1):45-55. View Abstract
  21. Guidelines for Transport of PACU Patients to Inpatient Units by Clinical Assistants. Clinical Practice Guideline. 2004. View Abstract
  22. Surgical team training in airway management using medical simulation. International Meeting for Medical Simulation; Albuquerque, New Mexico. 2004. View Abstract
  23. Resuscitation or do-not-resuscitate: decision making during a crisis in a simulated environment. International Meeting for Medical Simulation; Albuquerque, New Mexico. 2004. View Abstract
  24. “Does Training Academic Anesthesia Faculty in Crisis Resource Management Change Self- Perceived Performance in Managing Real Clinical Events”?. 2003 ASA Meeting Abstracts 2003. 2003. View Abstract
  25. Guidelines for Determining Post-PACU Placement. Clinical Practice Guideline. 2003. View Abstract
  26. Anesthesia Faculty Responsibilities in the PACU. Manual of Anesthesia Faculty Responsibilities. 2003. View Abstract
  27. Medical Simulation and Patient Safety: Implications for Ambulatory SurgerySurgery (Syllabus, Joint Meeting of the 5th International Congress on Ambulatory Surgery and the Annual Meeting of the Society for Ambulatory Anesthesia). 2003. View Abstract
  28. Simulation Debriefing I: An Introduction to Debriefing in the Simulation Environment (Syllabus, Center for Medical Simulation Instructor Series). 2003. View Abstract
  29. “The Probe Methodology for Measurement of Team Information Sharing in the Simulated Environment.”. Presented at International Meeting on Medical Simulation, San Diego, CA. January 2003, Anesth Analg. 2003; 97(2S):S10. View Abstract
  30. “Sustaining Development of Crisis Resource Management Training for Academic Faculty: A New Approach to Continuing Education.”. Presented at International Meeting on Medical Simulation, San Diego, CA. January 2003, Anesth Analg,. 2003; 97(2S):S10. View Abstract
  31. “Sustaining development of crisis resource management training for academic faculty: a new approach to continuing education.”. Fort Myers, Florida. February 2003. Pediatric Anesthesiology. 2003. View Abstract
  32. Overnight Care of Patients in the PACU. Clinical Practice Guideline. 2003. View Abstract
  33. “The probe methodology for measurement of team information sharing.”. Fort Myers, Florida. February 2003; Pediatric Anesthesiology. 2003. View Abstract
  34. “Testing probes, a new method of measuring teamwork attributes in simulated scenarios.”. Anesth Analg. 2002; 95(2S):A4. View Abstract
  35. “Crisis Resource Management for Academic Anesthesia Faculty.”. Anesth Analg. 2002; 95(S2):A46. View Abstract
  36. <i>Worst Case Senario: Simulation Training for Bioterrorism</i> (WFXT 25, Evening News, David Wade). 2002. View Abstract
  37. “Academic Pediatric and Adult Anesthesia Crisis Resource Management Training: A New Educational Approach.”. Pediatric Anesthesiology 2002; Miami Beach, Florida. 2002. View Abstract
  38. Guidelines for Treatment of Postoperative Nausea and Vomiting. Clinical Practice Guideline. 2002. View Abstract
  39. The Virtual Operating Room (Syllabus, Practical Aspects of Pediatric Anesthesia Hands-on-Workshop). 2002. View Abstract
  40. A randomized multicenter study of remifentanil compared with halothane in neonates and infants undergoing pyloromyotomy. I. Emergence and recovery profiles. Anesth Analg. 2001 Dec; 93(6):1380-6, table of contents. View Abstract
  41. “Testing Probes, A New Method of Measuring Teamwork Attributes in Simulated Scenarios”. Society for Technology in Anesthesia. Scottsdale, Arizona. 2001. View Abstract
  42. “Does Participating in Realistic Simulation Prior to Anesthesia Residency Increase the Perception of Comfort and Performance”?. Society for Technology in Anesthesia. Scottsdale, Arizona. 2001. View Abstract
  43. Perioperative Care Initiatives. Guidebook for Children's Hospital Staff Physicians. 2001. View Abstract
  44. “A Randomized Multicenter Study of the Safety and Efficacy of Remifentanil versus Halothane in Neonates Undergoing Surgery for Pyloric Stenosis.”. ANESTHESIOLOGY. 2000; 93(3A):A1279. View Abstract
  45. “The Effect of Remifentanil and Halothane on Postoperative Breathing in Neonates and Infants Undergoing Pyloric Stenosis Repair.” The effect of remifentanil and halothane on postoperative apnea in neonates and infants.”. ANESTHESIOLOGY. 2000; 93(3A):A1287. View Abstract
  46. Video teleconferencing with realistic simulation for medical education. J Clin Anesth. 2000 May; 12(3):256-61. View Abstract
  47. <i>HealthWatch: Simulation Training for Doctors</i> (WLVI 56, Evening News, Stephanie Leydon). 2000. View Abstract
  48. <i>Medical Report: Simulation in Medicine</i> (WBZ 4, Evening News, Virgina Cha). 2000. View Abstract
  49. “The Effect of Remifentanil and Halothane on Postoperative Breathing in Neonates and Infants Undergoing Pyloric Stenosis Repair”. Society for Pediatric Anesthesia. Fort Myers, Florida. 2000. View Abstract
  50. “The Safety and Efficacy of Remifentanil as Compared to Halothane in Neonates Undergoing Surgery for Pyloric Stenosis.”. Society for Pediatric Anesthesia. Fort Myers, Florida. 2000. View Abstract
  51. “Does Participating in Realistic Simulation Prior to Anesthesia Residency Increase the Perception of Comfort and Performance”?. Society for Technology in Anesthesia. Orlando, Florida. 2000. View Abstract
  52. <i>Healthbeat: Medical Simulation</i> (WCVB 5, Evening News, Timothy Johnson). 1999. View Abstract
  53. “Atypical Epiglottitis. A Complication of Immunosuppressive Therapy in a Post-Transplant Patient”. Pediatric Anesthesiology; Las Vegas, Nevada. 1999. View Abstract
  54. "Pharmacoeconomics of Remifentanil in Pediatric Patients". Am J Anesthesiology. 1999; XXVI(4):160-1. View Abstract
  55. "Computerized Realistic Simulation: A Teaching Module for Crisis Management in Radiology". AJR. 1999; 172:301-304. View Abstract
  56. “Pharmacoeconomics of Remifentanil in Pediatric Patients”. Association of Anesthesia Clinical Directors 11th Annual Meeting; Orlando, Florida. 1998. View Abstract
  57. “Intravenous vs. Inhalation Anesthetic Agents in Pediatric Patients: A Cost Analysis”. Pediatric Anesthesiology; Las Vegas, Nevada. 1998. View Abstract
  58. Orientation to the Post Anesthesia Care Unit. Fellow Handbook. 1998. View Abstract
  59. Simulation Training for HMS Attending Staff (Syllabus/Course Outline). 1998. View Abstract
  60. “Development of Wide QRS Complex Rhythms During Induction of Anesthesia”. Post Graduate Assembly of the New York State Society of Anesthesiologists. 1997. View Abstract
  61. “Overreaction to Latex Allergy?” Letter to the Editor. Anesth Analg. 1997; 84:467-8. View Abstract
  62. “Critical Event Performance After Training in Anesthesia Crisis Resource Management.”. Post Graduate Assembly of the New York State Society of Anesthesiologists. 1996. View Abstract
  63. “Can Anesthesia Crisis Resource Management Training Affect Performance in Critical Events?”. The 2nd Rochester Conference on Simulators in Anesthesiology Education. 1996. View Abstract
  64. “In-Vivo Indentation of the Cerebral Cortex” . Ann Conf Engineering in Med Biol. 1985; 86. View Abstract
  65. Modeling of Tissue Properties of Mammalian Brain (Senior Design and Masters Thesis, University of Pennsylvania School of Engineering and Applied Science). 1985. View Abstract

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