Survey of residency training in preoperative evaluation.

CHANGES in the healthcare system have promoted the evolution of anesthesia from an intraoperative to a perioperative practice. The growing emphasis on the reduction of costs, the improvement of medical outcomes, and the maintenance of high-quality care has created professional opportunities and intellectual challenges for anesthesiologists. Anesthesiologist involvement in the management of surgical patients in a preoperative clinic has been shown to decrease unnecessary testing and costs, reduce operating room delays and cancellations, and improve patient and physician satisfaction. Continued improvement in preoperative assessment, however, may rely on educating anesthesiologists in the skills of physical diagnosis and patient assessment, personnel and business management, and conducting or understanding outcome-based research. We hypothesized that the majority of accredited anesthesiology residency training programs do not support or encourage resident development of these necessary skills. Therefore, we surveyed U.S. residency programs with respect to their arrangements for preoperative assessment and how residency training in this area is accomplished.