Blog 24: Last Presentation Reflection

(1) Positive Statement

What are you most proud of in your block presentation and/or your senior project? Why?


My activity went by really well. I'm very happy that the audience was very much into the activity I had created and I'm so thankful that Mr. Pang said that it was one of the best he's seen in a long time. I was honestly surprised at how much fun everyone seemed to be having throughout the game.


(2) Questions to Consider

a.     What assessment would you give yourself on your block presentation?  Use the component contract to defend that assessment.

I think I should get an AE for this presentation because I made sure to include what's required for the presentation and I also had a plethora of props and tools that directly correlate to my topic. I made sure to reference sources and my mentorship throughout my presentation and show where I got my information from. I had a lot of fun presenting and I'm thankful that my audience was very responsive (aka laughed at my jokes). I warmed up as the presentation went along and there was a lot of information I had to run through, so I'm so glad it turned out well in the end.

b.     What assessment would you give yourself on your overall senior project? Use the component contract to defend that assessment.

I think I should get an AE for the project this year. I've done all my assignments and I put a lot of work into making sure my other presentations throughout the year were the best I could produce. I spent a lot of time going out and talking to experts in the field of anesthesiology. I wanted to gain insight from several different angles of the topic, so I interviewed several people, shadowed at different hospitals, and looked at other sources (books, articles, journals, videos, documentaries, etc.)

(3) What worked for you in your senior project?

What worked for me was my access to experts in anesthesiology. I was lucky enough to find a mentor that let me see such a wide view of what the job entails and I'm so thankful for that experience. I was able to even talk to patients and see the entire process for each procedure in a day. My mentorship was definitely a key factor that helped me narrow down my project.

(4) (What didn't work) If you had a time machine, what would you have done differently to improve your senior project?

Even though I was lucky enough to have access to experts like my mentor, I was held back by the fact that I have to be 18 years old to legally shadow under some doctors that I wanted to follow throughout the day. I wanted to follow a couple doctors in the hospitals that they worked in, but because I'm not of legal age yet, I had to pass the opportunity. 

Another problem I came across was HIPAA laws, so basically the doctor-patient confidentiality laws.With each patient, I had to ask if I could be present for their procedure and I had to ask if I could take pictures during their procedure. I was lucky enough to be allowed to do so, but it was still something I always had to keep in mind whenever I went to mentorship.

(5) Finding Value

How has the senior project been helpful to you in your future endeavors?   Be specific and use examples.

I had always been influenced by my parents' jobs as doctors throughout my life. I had been thinking about pursuing a career in medicine but I was very unsure. This senior project gave me that little push to put myself out there and learn from the experts. This really motivated me to pursue medicine (at least for now) and I had such a fun experience gaining more and more information. Whenever I would go to mentorship, I looked forward to watching cases and seeing how each procedure differed from the last. I found a lot of enjoyment (as morbid as this probably sounds) in seeing the surgeon cut open the patient and being able to see the patient still breathing (their chests would move up and down as they took breaths). The best part is being able to share these stories with others because it's an exciting feeling. I'm mostly thankful for the amazing experiences that I had throughout the year and I feel it was a sort of "leg up" for what I want to do in the future. 

Exit Interview

(1) What is your essential question, and what are your answers?  What is your best answer and why?

EQ: How can an anesthesiologist best ensure a patient's safety and comfort for surgery?

Answer 1: An anesthesiologist can best ensure a patient's safety and comfort for surgery by being well-versed on the drugs used for surgery to maintain body functions.

Answer 2: An anesthesiologist can best ensure a patient's safety and comfort for surgery by monitoring a patient's vital body functions through use and full knowledge of anesthesia machines.

Answer 3: An anesthesiologist can best ensure a patient's safety and comfort by reviewing the patient's history and background.

My best answer is my Answer 1, because drugs are a major part of an anesthesiologist's job. They can interpret readings from their machines and look through patient charts to plan for their anesthesia care, but without having drugs and knowing how to use them, they can't proceed with their task. They can determine if the patient is having trouble breathing or if the patient is uncomfortable with the help of monitors, but could do nothing to help that if they don't have the tools to help them.

(2) What process did you take to arrive at this answer?

Once I had narrowed down my 3 answers, I started asking the medical professionals that I interviewed what they thought. The response that stood out to me most was that of Dr. Imelda Murillo. She said that you can't call yourself an anesthesiologist if you don't know how to handle the drugs. There are so many drugs to understand and so many methods to use them depending on the individual patient. With other research, too, I have found that drugs are the key to anesthesia. A patient cannot be rendered unconscious without medication and cannot feel less pain without the aid of medication. Monitors are to show the effects of the drugs and the condition of the patient throughout, but the patient cannot be helped if not given a mixture of medications.

(3) What problems did you face?  How did you resolve them?

I had trouble narrowing down 3 answers, let alone a best answer. There are so many layers to the job of an anesthesiologist that summarizing them to concise wording proved difficult. However, what helped me the most were my mentorship experiences and interviews. This is why I decided to do extra mentorship hours for my IC 1 and shadowed under different anesthesiologists from other hospitals for my IC 2. I wanted to get a better idea of what anesthesiologists do. Just by watching them and talking to them I gained more insight than just reading articles that have the basics or generalize the job that they really do.

(4) What are the two most significant sources you used to answer your essential question and why?

My interview and shadowing experience with Dr. Zhuang T. Fang from UCLA was a major contributor to my findings. I was exposed to so much more than I had imagined and I was lucky enough to have help from someone that not only is an experienced anesthesiologist, but also a professor that teaches doctors how to specialize in anesthesiology. He helped me understand the more complex concepts and it definitely enhanced my project.

Other major resources I used were 2 books: Anesthesiology and Anesthesia Crash Course. Though simply titled, they both put seemingly confusing and overwhelming concepts into layman's terms. This helped me understand at least the basics as to the tools, machines, medications, and duties of an anesthesiologist and how they do it. In fact, Anesthesiology included a chapter that talked about Mallampati Classification, which I had used for my hook activity.

Blog 22: Independent Component 2

LITERAL
(a)“I,  Julianne General, affirm that I completed my independent component which represents 30 hours of work.”
(b) Cite your source regarding who or what article or book helped you complete the independent component.

For this independent component, I shadowed under 3 different anesthesiologists to gain more insight into how other anesthesiologists work aside from my mentor. I followed Dr. Zhuang T. Fang (from UCLA Stein Eye Center), Dr. Park (another doctor from Desert Valley Medical Center), and Dr. Lorna Wood (from Montclair Medical Center).

(c) Update your Independent Component 2 Log (which should be under your Senior Project Hours link)

(d) Explain what you completed.   

For each of the 3 doctors, I shadowed for at least 10 hours over the course of different days. And each doctor specialized in different aspects. For example, Dr. Zhuang T. Fang from UCLA is an attending for anesthesia residents and he specializes in anesthesia for eye surgeries. When I was with Dr. Park, I got to see a lot of urological surgeries (most patients have kidney stones). And when I was with Dr. Lorna Wood, I got to see a lot of OB cases, so they were epidural placements and deliveries.
 
(e) Defend your work and explain the component's significance and how it demonstrates 30 hours of work.   Provide evidence (photos, transcript, art work, videos, etc) of the 30 hours of work.   

Because my essential question asks about how an anesthesiologist is able to ensure the safety and comfort of their patients, I didn't want to just see how one person does their job. My mentor is very experienced and has helped me so much along the way, but people do a lot of things differently. I thought that by exploring other areas that anesthesiologists are also involved in, it could help better support the answers I could come up with for my EQ. So, I spent days with 3 different anesthesiologists to see different aspects of the job.

Here are some photos I've taken:

UCLA Stein Eye Center (I was with Dr. Zhuang T. Fang)

(This is the fancy sign at the front of the building)

(This is the entrance to the beautiful new building. It was so fancy!!)

(This is the observation room adjacent to OR 1. I had to go down a crazy flight of stairs from the main entrance to get here and they had a fancy machine that gives you scrubs.)

(This was my view of the operating room before one of the surgeries started.)

(Unfortunately, due to HIPAA laws, I was not allowed to take photos of the patients having surgery, but I was able to sneak some photos while the lights were off. You can sort of see the screen of a person's eye while getting cataract surgery.)

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Montclair Medical Center (I was with Dr. Lorna Wood)

(This is one of the hallways in the OR dept.)

(This is one of the supply rooms stocked with a bunch of medical supplies.)

(This is Dr. Lorna Wood showing a breathing mask.)

(Dr. Wood is checking the schedule for the day's surgeries.)

(These are more supplies that stock the OR. There was a lot of stuff there.)

(This is me standing next to a baby warmer/incubator for c-sections.)

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Desert Valley Medical Center (I was with Dr. Park)

(This is one of the operating rooms with a Da Vinci machine on the left.)

(I got to help set up the operating table for one of the cases that day.)

(This is me while we waited for the patient to be brought down from the patient floors.)

(This is known as a glidescope. It's a fancy version of a regular laryngoscope blade because it has a camera and light.)

(This is a propofol infusion pump.)

(This is me in the waiting room after a long day.)

(f)How did the component help you answer your EQ? Please include specific examples to illustrate how it helped. 

This component helped me see the different sides of anesthesia that I had not known much about. Because my mentor works mostly on "bread and butter" surgeries. I wanted to experience how the principles that my mentor had taught me applied to other aspects of the job of an anesthesiologist. And in watching these 3 other doctors, I had such a great experience learning from them and getting to see how the job is done.

For example, one thing that Dr. Park said to me that has stuck to me was about how he thinks of putting a patient under anesthesia. He said it's sort of like flying a plane. You start out by putting them under anesthesia slowly until they're completely out and you keep them at that "altitude" throughout surgery. Once you know surgery is about to be done (in his analogy, once you're arriving at your destination), you can start to slowly wake up the patient. It's funny because I remember that as he was telling me this, as if his timing was so perfect, the patient started responding and waking up from a surgery that had just finished.

Another example is my experience going to UCLA. Being that Dr. Fang is a professor, he was very knowledgeable and explained whatever he was doing throughout the day. He allowed me to follow him as he checked on his patients before surgery and there were a lot of anesthesia residents roaming around the facility as well. Dr. Fang even gave me some of his published works regarding anesthesia that I was able to use as resources. One of those that I found very fascinating was his mixture of drugs that he uses when he puts his patients under Monitored Anesthesia Care (MAC). I guess I hadn't thought much about putting the drugs all in one large syringe, as I had only seen drugs laid out individually in small syringes prior to visiting. It was this experience that really helped me form my answer 1 because I saw him use this mixture on many of his patients. I saw how it affected them and to see their satisfaction in the end seemed very rewarding for Dr. Fang. I could tell that he really cared about his doctor-patient relationship. He even told me that he still keeps in great contact with a few of his patients and he would email them to see how they're doing.

Dr. Lorna Wood also talked about this aspect with me a lot. She explained to me why she loves doing what she's doing (and also warned me not to go into medicine if you just want the good pay). She told me about her struggle of coming to America from the Philippines and having to retake tests to certify that she can practice in the United States. She said that it's very important to care about your patients because you won't enjoy your job otherwise. And despite the hard work she has to do every day, she told me it's all worth it in the end if she can help bring someone into the world or save someone's life. When I asked her my essential question and her thoughts on it, she ensured that I also mention the importance of the doctor-patient bond and trust that has to be developed in the minutes that anesthesiologists have before a surgery. Ensuring a patient's safety and comfort can't come if the doctor doesn't first care about their patients. And this brought about a different perspective to my project that I hadn't really thought about before, so for that I'm very grateful that Dr. Wood was able to share that with me.

Blog 17 - Interview 4 Reflection

Interview Audio

1. What is the most important thing I learned from the interview? 

This interview helped me focus on what my best answer is for my Essential Question. It helped me fully define what my best answer will be for my final presentation. I made sure to ask questions that related to my 3 answers and this interview provided support for the answer I was leaning towards before the interview.

2.  How will what I learned affect my final lesson?

As stated, this interview gave me further support for what I had been thinking of to be my best answer to my Essential Question. I had narrowed it down to 3 topics and of the three, Dr. Murillo helped me focus on the aspect of the drugs used during surgery. There are a number of quotes from this interview that I will definitely consider using for my presentation.

Fourth Interview Questions

1.  Who do you plan to interview?  What is this person's area of expertise?

I plan to interview my mom, who is an anesthesiologist with over 20 years of experience, or Dr. Edgar Guerero, who has also been an anesthesiologist for 20+ years.

2.  Post 20 open-ended questions you want to ask an expert in the field concerning your senior project. Your focus should be finding answers to your EQ.

1. What do you enjoy most about your job?
2. What do you dislike about your job?
3. What are the most common surgeries you help with?
4. How often would you say complications arise while working?
5. What are typically the most difficult patients to care for? Why?
6. What has been the most difficult aspect of anesthesia to learn?
7. What drugs do you use most often?
8. How often do new drugs replace older ones?
9. How important would you say the medications in a procedure are?
10. What are the main monitors you use? What are they for?
11. To you, what are the most important monitors?
12. What key factors do you pay attention to when creating your plan for anesthesia for each patient?
13. On average, how do patients with an alcoholic history react to anesthesia? drug users? smokers?
14. How important is it to know about the patient's history and background?
15. How do you go about not knowing a patient's full history and background in the state of emergency?
16. What are a few memorable patients that you can recall?
17. Being that anesthesiologist do not get to spend as much time with patients as other doctors, how do you establish a great doctor-patient relationship within the short span of time before surgery?
18. What do you believe is the main duty of an anesthesiologist?
19. Which of these three do you believe is the best way an anesthesiologist can ensure a patient's safety and comfort for surgery: knowing your drugs, monitoring the patient, or knowing patient history and background? Why?
20. What advice would you give someone, like myself, who is considering becoming an anesthesiologist in the future?

Blog 19: Third Answer

• EQ 
• How can an anesthesiologist best ensure a patient's safety and comfort for surgery?
• Answer #3 (Write in a complete sentence like a thesis statement)*
• An anesthesiologist can best ensure a patient's safety and comfort by reviewing the patient's history and background.
• 3 details to support the answer
• Knowing if the patient is a drug addict, smoker, or alcoholic is crucial to the anesthetic procedure because they need special care.
• Knowing if the patient has had previous surgeries can give the anesthesiologist an idea of how the patient reacts to certain drugs.
• Being well-informed of the patient's allergies before surgery is important.
• Receiving a detailed list of all medications the patient takes regularly is important.
• The research source(s) to support your details and answer
• *Best Source* 52a) Newhouse, Beverly J., MD. Anesthesia Perioperative Evaluation Syllabus. 2005. WHAT IS THE PURPOSE OF THE ANESTHESIA PR WHAT IS THE PURPOSE OF THE ANESTHESIA PREOPERATIVE EVALUATIONEOPERATIVE EVALUATION. University of California, San Diego, San Diego. <http://anesthesia.ucsd.edu/som/anesthesia/education/residency-program/curriculum/Documents/Preopsyllabus.pdf>
• 3a) Glidden, Randall S. "Perioperative Anesthetic Management." Anesthesiology. Pages 9-26. Baltimore: Lippincott Williams & Wilkins, 2003. Print.
• 30) Novak, MD, Richard. "WHY DOES ANYONE DECIDE THEY WANT TO BECOME AN ANESTHESIOLOGIST?" Wordpress. Wordpress.com, 11 Sept. 2013. Web. 30 Oct. 2015. <http://theanesthesiaconsultant.com/2013/09/11/why-does-anyone-decide-they-want-to-become-an-anesthesilogist/>.
• 39) "Anesthesia Options, Risks, and Side Effects." Johns Hopkins Medicine. Johns Hopkins. Web. 22 Jan. 2016. <http://www.hopkinsmedicine.org/howard_county_general_hospital/services/surgery/anesthesiology.html/anesthesia_options_risks_and_side_effects.html>
• 45) Mayo Clinic Staff. "General Anesthesia: What You Can Expect." Mayo Clinic. Mayo Clinic. Web. 11 Feb. 2016. <http://www.mayoclinic.org/tests-procedures/anesthesia/details/what-you-can-expect/rec-20163594>.
• Concluding Sentence
• It is crucial for an anesthesiologist to know a patient's history and background, because some patient require special care, such as more drugs during surgery in order to keep the patient safe.

Blog 18: Answer 2

1.  What is your EQ?

How does an anesthesiologist best ensure a patient's safety and comfort for surgery?

2.  What is your first answer? (In complete thesis statement format)

An anesthesiologist can best ensure a patient's safety and comfort for surgery by being well-versed on the drugs used for surgery to maintain body functions.

3.  What is your second answer? (In complete thesis statement format)

An anesthesiologist can best ensure a patient's safety and comfort for surgery by monitoring a patient's vital body functions through use and full knowledge of anesthesia machines.

4.  List three reasons your answer is true with a real-world application for each.

Answer 1:

• Knowing the drugs and what they do
• Anesthesiologists have to be experts in pharmacology. There are a wide range of drugs that anesthesiologists use to maintain a patient's body functions. For example, in order to render a patient unconscious, they use a sedative, like Propofol. To paralyze the muscles, they use a muscle relaxant, and a reversal drug as well. They use a large selection of narcotics to rid of pain before, during, and after surgery. Additionally, these medications have side effects, such as raising and lowering blood pressure. There are drugs to combat this as well.
• Making a patient comfortable through use of drugs
• Throughout the process of undergoing surgery, patients are often experience anxiety or fear. With the aid of drugs, anesthesiologists can ensure that patients will be relaxed before even entering the operating room. For example, Midazolam is a drug that is given before surgery to calm a patient. It also causes temporary amnesia, making the patient not remember anything that happens in the operating room.
• Labeling of syringes
• Anesthesiologists are sure to label their syringes for sake of patient safety. There have been studies showing that the labeling of syringes has greatly improved patient care, as it is less likely for there to be a faulty drug given to the patient. Most medications are clear fluids, so labeling them is a key factor to patient safety. Drugs are categorized by type, like narcotics are colored a light blue, hypnotic drugs are yellow, muscle relaxants are bright red, etc.

Answer 2:

• Wide array of machines
• There is a wide array of machinery that is used during surgery for monitoring the main body functions of a patient. For example, heart rate, blood pressure, oxygen level, CO2 level, other gas levels, and even brain waves are all monitored. Each monitor gives readings that cannot be observed otherwise. Additionally, new and improved technologies are produced every year with more technologically advanced machinery. In fact, my mentor has told me that anesthesiology is one of the fastest improving medical field in patient safety.
• Provides a warning before things go wrong
• In turn, with advanced machinery screening a patient throughout a surgery, this increases a patient's safety. Simply having all the equipment is not enough. Anesthesiologists have to be diligent and pay attention to the monitor readings. By watching the monitors, anesthesiologists can tell beforehand if a muscle relaxant is starting to wear off or if a patient is having trouble breathing.
• Recording monitor readings throughout surgery
• Every surgery I've observed, I have seen the anesthesiologist record important monitor readings at certain time intervals throughout procedures. This is not only to show that the anesthesiologist was paying attention to monitors during surgery, but also to show that the patient was comfortable. The monitors would show if the patient was not able to breath or was in an unstable condition. Thus, keeping record of how the patient was doing as the procedure progresses can have an effect on safety and overall comfort.

5.  What printed source best supports your answer?

Sources located in Working Bibliography

Answer 1: Sources 37b

Horton, Charles. "Better Living Through Chemistry." Chapter. Anesthesia Crash Course. New York: Oxford UP, 2009. 27-45. Print.

Answer 2: Sources 21

Subrahmanyam, M., and S. Mohan. "Safety Features in Anaesthesia Machine." Indian Journal of Anaesthesia. Medknow Publications & Media Pvt Ltd, 1 Oct. 2013. Web. 21 Oct. 2015. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3821264/>

6.  What other source supports your answer?

Sources located in Working Bibliography

Answer 1: Sources 3b, 8, 15, 33, 36, 37b, 42
Answer 2: Sources 1, 21, 24, 37a, 46

7.  Tie this together with a  concluding thought.

With anesthesiology being one of the fastest improving medical fields, safety and comfort are the main focus. Every year, there are better, more advanced machines and techniques that are discovered. But the main ways in which anesthesiologists ensure that their patients are safe and comfortable are through monitoring of machines and being well-versed in the medications used in surgery. I have seen these methods used many times while at mentorship. Implementing these factors plays a role in possibly saving a person's life.

Blog 17 - Interview 3 Reflection

[Dr. Zhuang T. Fang works here at the Wasserman Building at UCLA.]

INTERVIEW LINK

1. What is the most important thing I learned from the interview?  

This interview has shown me a new perspective of anesthesiology. Because Dr. Fang teaches residents at UCLA what it takes to be an anesthesiologist, I saw that anesthesiology has a lot to do with having good judgement and knowing your patients. One thing that stood out to me in this interview was when I asked about the most challenging aspect of teaching anesthesia. Dr. Fang said that the most difficult thing for him is trying to make the right judgement. If a resident harms the patient, he ultimately is responsible for what happens to that patient. He said that it is much easier for him to go in and do the surgery himself, but he enjoys teaching others what he knows and wants to pass on the knowledge he has gained over the years. When he is with residents, he has to decide and find the balance between letting the resident have his or her freedom to develop their skills and practice but also knowing when to step in and take over. This helped me better understand the qualities that make a great anesthesiologist.

2.  How has your approach to interviewing changed over the course of your senior project?

The focus of my interviews has shifted to knowing more about what it takes to be an anesthesiologist. Because as I talk to more people about their experiences, I find that my interest grows even more. It has brought my research further into justifying the answers that I have for my EQ. I have seen the different ways people handle different situations to see what works. Initially, my interviews started out a bit broad and general, but over the course of the year, as I learn more about the subject, I find that I can get into deeper conversations about anesthesiology that I wouldn't have thought of in the beginning of the year.

Blog 16: Independent Component 2 Approval

[UCLA Wasserman Building.]

1.  Describe in detail what you plan to do for your 30 hours.

I plan to further observe procedures done by anesthesiologists from other hospitals outside of my mentorship to broaden my knowledge of how other anesthesiologists may perform procedures differently apart from my mentor. There are two other hospitals in particular that I plan on observing other anesthesiologists at work. There is a third hospital that I plan to visit as well, however I still have to arrange for a day.

2.  Discuss how or what you will do to meet the expectation of showing 30 hours of evidence.

On Friday, February 12, I will be visiting the UCLA Wasserman Building at the Stein Plaza on Westwood Blvd. It is the neurosurgery building at UCLA. There I will shadow under Dr. Zhuang T. Fang, the anesthesiologist I interviewed for Interview #3. He allowed me to observe surgeries for the whole day. (basically from 7AM until all surgeries for the day are done).

I plan to also observe surgeries at the Chino Valley Medical Center. There I will also observe surgeries throughout the day under another anesthesiologist. I have not yet arranged for a specific day, but watching more surgeries done by a variety of anesthesiologists is more beneficial.

I volunteer at the San Antonio Regional Hospital in Upland in Maternity every Sunday. There are always anesthesiologists that come by regarding patients and I often get the chance to ask them questions and if asked, observe epidurals. What I am most interested in for this case is how anesthesiologists interact with their patients to make them more comfortable.

3.  Explain how this component will help you explore your topic in more depth.

Dr. Zhuang T. Fang is an attending for UCLA anesthesiology residents, meaning that he teaches and watches students perform anesthesia procedures for training. I feel that with his many years of experience will be helpful in understanding more about my topic.

I have had previous experience at Chino Valley Medical Hospital, but have not really observed procedures there. I have known different doctors at the hospital and watching different anesthesiologists perform procedures can allow me to get a better grasp of how anesthesiologists can make patients safer and more comfortable. People in general do the same tasks differently, so being able to watch how other doctors of the same profession perform anesthesia can offer more options for what I can look into regarding research, more support for answers to my EQ, and about the topic in general. I expect that the time spent at UCLA and at Chino Valley Medical Center will take up a majority of the time for this IC. However, I feel that some time can be spent around anesthesiologists at San Antonio Regional Hospital to see how they interact with patients undergoing labor, as this is still an important aspect of anesthesiology. Also, I volunteer every Sunday at the hospital in the Maternity Dept. in which I see and interact with these patients all the time. With this, however, I aim to focus more on the anesthesiologist's interactions with the patients and how they communicate, as this is related to a possible EQ answer.

Independent Component 1

LITERAL

“I, Julianne General, affirm that I completed my independent component which represents 30+ hours of work.” My mentorship at Desert Valley Medical Hospital under Dr. Richard Kakes has helped me learn more about anesthesiology in the field and in action. Throughout my mentorship, I have seen a variety of surgeries, such as gallbladder removal, appendix removal, knee replacement (which is another story in itself because I nearly passed out from the smell), circumcisions, different prostate surgeries, cyst removal, and also repairing of fractures. Each day brings about a new experience and another set of fun stories to share.

 
INTERPRETIVE 

I completed extra hours of mentorship for this independent component, because watching what actually happens with the job is the best way to learn a topic like anesthesiology. I spent extra time observing what happens, during surgeries and this has helped me attain a greater grasp of what I read in research I find on anesthesia. I know more about the drugs used and the most I watch my mentor intubate a patient, the more I notice minor details that an experienced anesthesiologist would do to further ensure a patient's safety.

Here are some photos while at mentorship:

APPLIED

There have been several cases that have stuck out to me that have broadened my knowledge of anesthesia. For example, the story I shared during my lesson 2. My mom and I were about to leave for the day when my mom received a call from the ER saying that a woman was dying and needed emergency surgery. She had ruptured a stomach ulcer and when we saw her she was dying right in front of us. We brought her in to the OR and I sat in the corner and watched as she was quickly put under anesthesia. We were there for 2 hours and throughout that time, her condition was very unstable. In the end, we took her to the ICU because she was still in critical condition. This experienced helped me figure out an answer to my EQ, being that anesthesiologists should be well-versed in the drugs they use.

Another experience was when I walked in the OR and my mentor was wrapping up a surgery with a patient that was just waking up. But I was totally surprised when I saw the tall, grown man sobbing in so much pain after having his gallbladder removed. My mentor told me that he was a drug addict, so the drugs don't mix well with any narcotics he was able to give him throughout the surgery. He also said that this is normal for people that abuse drugs. It just surprised me because I hadn't seen anything like it before.

I can also recall one time that I was allowed to stand right where the surgeon was standing. For one case, a woman had to have 2 masses removed from her fallopian tubes. It was a long surgery and at one point the surgeon had to take a short break. When he came back, he asked me if I wanted to stand on the stepping stool to look inside and see what he had been working on. It was quite a unique experience because not only did I get to see the inside, but I found it interesting to still see her lungs moving, still breathing for her while under anesthesia.

There was one time I watched a circumcision of a 10-year-old boy. He was very scared for his surgery and I watched as my mentor calmed him down by showing him the oxygen mask while still in the holding room. He talked to him very softly and explained that he it would be over before he knew it. And after the surgery, right as the boy was waking up, (and perfect timing, I might add), my mentor explained that usually children cry a lot as a reaction to anesthesia. It was just normal. And sure enough, the boy woke up already crying and shivering.

On my first day of mentorship, I had just finished watching the first surgery of the day. And as I was walking out of the OR, I suddenly heard a woman wailing and screaming in pain across the hallway. I saw the surgical team move her into another OR. She was about to give birth but needed an emergency c-section. It was a very interesting experience because in a matter of minutes, the woman went from wailing in pain to being under anesthesia.

Lesson 2 Reflection

1.What are you most proud of in your Lesson 2 Presentation and why?

I am proud of the fact that the activity went by much better than I thought it would. From what I saw, people seem engaged and wanted to participate in the activity. The fact that it was a game brought out a competitive aspect in the audience that made it fun and enjoyable to watch. Also regarding the activity, I am proud that the idea for it was inspired by a real event that I witnessed at mentorship, because it brought about a realness aspect to my debrief afterwards that put what I had been talking about in my lesson into perspective.

2. a.     What assessment would you give yourself on your Lesson 2 Presentation (self-assessment)?

I think I deserve an AE for this presentation.

     b.     Explain why you deserve that grade using evidence from the Lesson 2 component contract.

Throughout my presentation, I referenced my mentorship many times as well as resources for the information that I presented. I knew my EQ by heart, made time by talking for more than 10 minutes while allowing ample time for the activity afterward. I also brought props with me that I pointed out during my presentation and I used several props (syringes) for my activity. I made sure to reference my answer more than once so that I don't just glance over it.

3. What worked for you in your Lesson 2?

Over these past few months I have learned a lot about anesthesiology and when I had the chance to present what I have learned, I found it very exciting. I especially love to tell stories of things that I have observed while at mentorship and one of my favorite aspects is seeing people's reaction to the tools I would bring and explain during my presentation. I also really enjoyed the response I got from doing my activity. People seemed engaged and seemed to understand the connection between the activity and the answer to my EQ that I talked about.

4. What didn't work? If you had a time machine, what would you have done differently to improve your Lesson 2?

I would have added another rule to my activity that would have people wait for me to finish my statement in the simulation before allowing them to guess. It would be a slight improvement that I think could make a good change to make it more cohesive and organized.

5. What do you think your answer #2 is going to be?

My answer #2 would be closely monitoring the patient during surgery. (In other words, hooking up the patient to the several kinds of anesthesia monitors to check heart rate, blood pressure, consciousness, etc.)