International Anesthesia Education Forum

For over ten years a small group of physicians from the Department of Anesthesiology at the University of Utah has traveled to the second largest hospital in Ghana – the Komfo Anokye Teaching Hospital (KATH). Initially this trip focused on service projects such as ophthalmic, orthopedic, general, and urologic surgeries. As we developed a relationship with the anesthesia staff at the KATH, we realized that there was potential for us to assist in other ways.

The Chief of Anesthesia at the KATH, Dr. Gabriel Boakye, is a Ghanaian physician who completed his anesthesia residency in Germany, and returned to Kumasi. In 1987, he was instrumental in founding the only nurse anesthetist school in Ghana. In 2009 he certified forty-six graduates, totaling over four hundred since the school opened.

Refresher Course #1.

We began to assist Dr. Boakye with teaching in the anesthetist training school. However, eventually we saw a need for continuing education for established practitioners.
Our first ‘Refresher Course’ was held in a tiny lecture room in the KATH itself. We expected forty, but ultimately had eighty attendees.
Encouraged, the following year we held the course at a local hotel, enrolling over one hundred people.

Since then, we have averaged one hundred fifty attendees per year. Most of our participants are nurse anesthetists from Ghana, but a significant number of the few Ghanaian physician anesthesiologists also attend. In recent years, we have had anesthesia providers from adjacent countries (Cameroon, Togo, Côte d'Ivoire) also enrolling.

Our experience, and that of others suggests that in the developing world there are topics of universal interest to anesthetists. These include trauma management, obstetric anesthesia, pediatric anesthesia, and regional anesthesia. In addition, there are smaller topics that are of recurring appeal e.g. preoperative assessment, sickle cell disease, and anesthetic implications of infectious disease. Having such a relatively limited range of topics enables our course providers to develop ‘pedagogical content knowledge’ i.e. a well-organized and adaptable understanding of both the content and learners’ common conceptions and misconceptions. Given our clinical experience in the developing world, we are able to ensure that our lectures are relevant to the participants and their equipment, drugs, and medical infrastructure.

It has been suggested that increased in-country postgraduate training can contribute to slowing the medical ‘brain drain’ from medically underserved nations. In addition, we maintain that in an environment with limited access to equipment and medications, robust, up-to-date knowledge of physiology, pharmacology and anatomy are of the utmost importance – the buffer engendered by sophisticated monitors and fast-acting drugs must be replaced by a predictive wisdom.

After five years of successful courses, we felt we had a model that works. With a conviction that our courses are successful and desired and a commitment to help our colleagues in the developing world, we decided to take the above concepts and apply them to courses in other medically underserved regions. To this end, we founded the International Anesthesia Education Forum.

Our initial strategy was to add a new course site each year, so that in several years we would have four or five sites that we visited annually. Within a month of starting our networking and website, we had four definite course bookings for that year alone, and more course requests than we could accommodate. Even if not all of these sites wish a return visit, the enthusiasm for our courses had greatly outstripped our expectations and initial capacity.

We expected to seek funding in approximately five years when there would be enough demand to require a formal administrative position, and when frequent international airfares would become prohibitively expensive. Given the enthusiasm of our colleagues in the developing world, it appears that we will have to seek funding earlier than expected.

Dobson states, “The problem with teachers is the same as with pulse oximeters – there aren’t enough of them.” The main principle of the International Anesthesia Education Forum is to develop a true cooperative in which anesthesia professionals from all over the globe promote continuing education. In the long-term, our ambition is the same as older and more established organizations. We would endeavor to create a cadre of educators whose goal would be to teach the teachers, establishing self-sustaining regional centers of education with faculty who are willing and able to take a local leadership role in anesthesia education.