Assessment of Anesthesiology and General Surgery Residents’ Knowledge of HIV/AIDS & Implications for Residency Education

Research Article

Austin J HIV/AIDS Res. 2014;1(2): 6.

Assessment of Anesthesiology and General Surgery Residents’ Knowledge of HIV/AIDS & Implications for Residency Education

Antonio Hernandez Conte*1, Robert Wong1, Jason Park2, Jillian Gottlieb2, Jun Tang1, Troy LaBounty3

1Department of Anesthesiology, Cedars-Sinai Medical Center, USA

2Department of Internal Medicine, Cedars-Sinai Medical Center, USA

3Department of Medicine, University of Michigan Medical Center, USA

*Corresponding author: Antonio Hernandez Conte, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Suite 8211, Los Angeles, CA, 90048, USA

Received: October 17, 2014; Accepted: November 27, 2014; Published: November 29, 2014


Study Objective: The authors were interested in ascertaining if educational modules pertaining to HIV/AIDS were offered to anesthesiology and general surgery residents and to assess the fund of knowledge related to HIV/AIDS.

Design: An email with an electronically-linked survey was mailed to the program directors of all anesthesiology and general surgery programs in the U.S. approved by the ACGME. In addition, the respective residency directors were asked to complete a survey regarding HIV/AIDS education.

Setting: The study was conducted in anesthesiology and general surgery residency programs in the U.S.

Subjects: The subjects were anesthesiology and general surgery residents, as well as residency program directors of both specialties.

Interventions: Interventions consisted of survey questions and associated responses to the 16-question (residents) and 6-question (program directors) surveys.

Measurements: Correctness of responses was recorded on all questions of the surveys; descriptive statistics and chi-square analysis were performed.

Main Results: The majority of anesthesiology (86%) and general surgery (87%) residents responded that they had not received any formal education pertaining to HIV/AIDS. Although both groups demonstrated a basic fund of knowledge of HIV/AIDS, more detailed questions led to higher incorrect responses between the two groups. Both groups of residents (anesthesiology – 89%; general surgery – 87%) believed that they would benefit from additional HIV/AIDS education during their training. The majority of anesthesiology and general surgery programs do not provide formal didactic or clinical training modules related to HIV/AIDS, but they personally believe this to be an important issue that warrants education during training.

Conclusions: This nationwide survey demonstrated that anesthesiology and general surgery residents in the U.S. lack formalized education in HIV/ AIDS, and they admit that this education is desired during their training. The authors of this study recommend that formal educational modules pertaining to HIV/AIDS be implemented during residency.

Keywords: Anesthesiology residency education; General surgery residency education; HIV/AIDS knowledge; HIV/AIDS perioperative education


Since the initial reporting of the first clinical cases of the Human Immunodeficiency Virus-1 (HIV) and subsequent delineation of Acquired Immune Deficiency Syndrome (AIDS) thirty years ago, scientists and physicians have achieved a remarkable understanding of the pathogenesis of HIV, identified the clinical markers of progression from acute HIV infection to AIDS, defined the HIV/ AIDS clinical continuum and developed highly active antiretroviral treatment (HAART) [1-5].

In the 21st century, primary care physicians and infectious disease specialists are now effectively managing the long-term care of HIV seropositive (+) patients with great success. As a result of the aforementioned advances, persons with HIV and/or AIDS are living longer and more productive lives [6]. Due to the natural aging process, HIV/AIDS-associated pathology, and/or HAART-induced co-morbidities, patients with HIV/AIDS are presenting for surgical procedures at an increasing rate and for procedures similar to non- HIV infected individuals [7,8].

The majority of care in the perioperative setting in the United States is delivered by surgeons and anesthesiologists. Since the early days of the epidemic, these two medical specialties have been on the frontlines attending to the care patients with HIV/AIDS; however, their roles have dramatically changed from a supportive or palliative one to a more active role over the last fifteen years. The objective of this study was to ascertain if anesthesiology and general surgery residents receive formal exposure to HIV/AIDS didactic education and clinical training, as well as to evaluate basic fund of knowledge and responses to clinical situations pertaining to HIV/ AIDS. In addition, the authors also sought to objectively corroborate the presence or absence of formal HIV/AIDS-related educational programs in anesthesiology and general surgery residency programs by directly surveying program directors of both specialties.

Materials and Methods

Institutional Review Board (IRB) approval at Cedars-Sinai Medical Center was obtained prior to conducting this study, and the study is in full accordance with the principles set forth in the Helsinki agreement governing human medical studies. The primary tool utilized was a multiple-choice, voluntary survey posted on a web-based interface (, Portland, Oregon). A letter explaining the study and associated survey was sent by electronic-mail (e-mail) to all Accreditation Council of Graduate Medical Education (ACGME)-approved anesthesiology and general surgical residency program directors in the United States. A total of 132 anesthesiology and 247 general surgery ACGME-approved were listed in the online directory, however, only 93 anesthesiology programs and 169 programs provided e-mail contact information in the ACGME directory. Program directors were asked to forward the letter to their respective residents for review and voluntary participation; the email letter contained a direct link to the online survey posting which allowed anonymous completion and also contained online data collection, retrieval, and analysis tools. Residents were not able to view other respondent’s answers and were not informed as to the correctness of their responses.

The resident survey consisted of 16 questions with multiple-choice answers (“Yes/No”&“Best answer”). The survey questions ranged from general demographic details about level of training, size-of-city in which residency was located, presence of educational curriculum pertaining to HIV/AIDS, number of patients managed per year with HIV/AIDS, basic and advanced fund of knowledge questions for HIV/AIDS, hypothetical clinical situations, and self-assessment regarding need for further HIV/AIDS education (See Appendix A). Two questions were modified between the surgical and anesthesiology groups in order to more accurately assess specialty-specific issues of clinical care, however, the two questions were similar in nature and intent of discovery of knowledge base for that respective specialty so that comparison between the two specialties could be achieved.

Anesthesiology and general surgery program directors with listed email contacts were sent a letter requesting that they participate in a survey (see Table A) as well. The letter included an electronic link to an online survey composed of six multiple-choice questions. The survey’s purpose was to directly determine if educational modules pertaining to HIV/AIDS education were provided at their respective programs and to corroborate residents’ responses to the presence or absence of HIV/AIDS educational modules.