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This book provides an in-depth and complete guide explaining how to incorporate the strategic dialogue and strategic communication methods into the debriefing after the scenario, characteristics that make it unique. After examining all the aspects that allow a correct use of the simulation, such as knowledge of models, logical schemes, use of the different simulators, planning of the didactic activities and of learning process, this practical book aims to explore the advanced technique of the strategic debriefing. It encourages not only those who are approaching this new debriefing tool but also it provides a useful update to all those who are already more familiar with the standard debriefing after simulation technique.The strategic language, an effective tool in strategic psychotherapy and business problem solving, is ideal and complementary to the standard debriefing methods, making them more performing and functional because, next to common logic, it makes use of non-ordinary logical language. The book is intended for healthcare simulation debriefers and instructors, for hospitals’ managers, university teachers and to all the physicians who are increasingly showing interest in active teaching processes with simulation.

Within surgical disciplines, obstetrics and anesthesia carry a greater risk of medicolegal liability although with improved monitoring and practice standards issued by national scientific societies such as the American College of Obstetricians and Gynecologists (ACOG) and the American Society of Anesthesiologists (ASA). Pain relief is becoming an area of concern. Analgesia refers to the relief of pain without the loss of consciousness. Modalities of analgesia during childbirth include regional analgesia, systemic opioid analgesia, continuous labor support, pudendal blocks, immersion in water during the first stage of labor, sterile water injections in the lumbosacral spine, hypnosis, and acupuncture. Even though there are multiple options for labor pain management, women often experience pain during childbirth in accordance with their expectations. The ASA Closed Claims database has shown that since the 1990s the proportion of claims associated with general anesthesia has progressively declined while the proportion associated with regional analgesia has steadily increased although the majority of maternal injuries are minor (e.g., headache, back pain, pain during analgesia, neuropsychological consequences). In addition, it reported that postnatal depression may be more common when analgesia is not used and pain during labor has been correlated with the development of posttraumatic stress disorder. Furthermore, men are also affected by severe labor pain. A survey of first-time fathers showed that the men whose partners received an epidural felt three times as helpful and involved during labor and delivery and had less anxiety and stress, as compared with men whose partners did not receive an epidural. All these situations may reflect unrealistic expectations and dissatisfaction with parturient care, and litigation serves the purpose not only of reparation of injury and deterrence of standard of care but also of emotional vindication. This is especially true in Italy

This is a review of the most important articles of Minerva Anestesiologica of 2014

The comment of the article of anesthesia published in Minerva Anestesiologica in 2014

BACKGROUND: We organized a training program for oral fiber optic intubation (FOI) under conscious sedation. The efficacy of the program was evaluated by comparing the performances of experts and novices. METHODS: The training procedure was divided into two sessions: a theoretical session on difficult airways, the fiber optic bronchoscope (FOB), remifentanil, topical anesthesia and patient interactions; and a session involving simulations of the FOI technique on dummies. For in vivo FOI, we enrolled patients requiring orotracheal intubation for elective surgery. Electrocardiograms, mean arterial pressure was railroaded over the fiberscope, and tracheal intubati6 and 7) FOIs, respectively, joined the study. To reach ±23 bpm, P=0.02), and RR was decreased (from 16±3 to 12±4 bpm, P<0.05). No differences were recorded between the experts and less-experienced anesthesiologists. The average duration of FOI was 3.3±2.0 min for experts and 4.2±2.4 min for novices (P=0.03). Procedures were successful in both groups, with patients in each group being equally satisfied with the procedures. CONCLUSION: This study highlights the importance of a structured FOI training program, demonstrating that it is possible to learn to perform FOI proficiently by practicing on dummies.

This is a review of the most important articles published on Minerva Anestesiologica during the 2014