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Volume 3 Supplement 1

ESICM LIVES 2015

Trainee led intensive care unit induction - an educational and quality improvement project

Introduction

Under the leadership of the Faculty of Intensive Care Medicine, junior trainees from varied medical backgrounds are increasingly undertaking placements in Intensive Care Units (ICU) [1]. Unlike their predecessors, current trainees may have little prior training in advanced organ support (AOS), yet clinical responsibility may be high - a potential patient safety issue. Traditional senior-doctor led departmental induction may not rapidly adapt to the evolving requirements of current trainees [2].

Objectives

To assess the background, prior experience & confidence at managing AOS in a cohort of trainees at our institution. Satisfaction with the standard departmental induction programme (IP1) was also assessed.

To design a new induction programme (IP2); novel in the sole use of current unit trainees for its development & delivery, incorporating feedback from the initial assessment & tailored to the needs trainees from differing medical backgrounds.

To assess trainee confidence/satisfaction following IP2 & ensure project continuity.

Methods

Three written assessments were completed by two cohorts of trainees; Cohort 1 was assessed post IP1, Cohort 2 was assessed pre & post IP2.

IP2 design was based on feedback from Cohort 1 & took a structured approach to AOS, with five system-based presentations & a written handbook. IP2 was delivered as a half-day of interactive lectures prior to Cohort 2 commencing placements in ICU.

Electronic copies of IP2 content were handed over to Cohort 2 to facilitate future delivery.

Results

Cohort 1 (n = 8) included: 2× Core Medical trainees (CMT), 2× Emergency Medicine (EM) trainees & 3× foundation trainees (FT); with prior ICM experience: 3× none, 5× < 6 months. Cohort 2 (n = 6)) included: 1× CMT, 3 × FT & 2× anaesthetic trainees (AT); with prior ICM experience 3× none, 2× < 6 months & 1× < 12 months.

Assessment responses graded 0-5 (poor-excellent) were mean averaged. Pre & post IP2: trainee confidence at routine AOS management improved from 1.93 to 3.17; confidence at emergency AOS management improved from 2.17 to 3.33; understanding of AOS principles improved from 2.17 to 3.5. Overall satisfaction with induction improved from 2.38 to 4.83. (See Graph 1)

Conclusions

As ICM training expands in the UK, junior trainee confidence & experience cannot be taken for granted. Induction programmes tailored for trainees of differing medical backgrounds can improve knowledge, confidence at managing AOS & improve trainee satisfaction.

Such programmes need not be costly or consultant delivered. Our trainee led & delivered programme resulted in improved levels of trainee confidence, high levels of satisfaction & provided a legacy of teaching opportunity for trainees within the unit.

figure 1

Figure 1

References

  1. Nee P: The Faculty of Intensive Care Medicine. EMJ Supp. 2011, 28 (1(2)): January

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  2. Koshal S: Induction training for senior house officers in OMFS. Br Dent J. 2012, 213 (2): Jul 27

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Sumpter, J., Wijesuriya, J., Mccomb, R. et al. Trainee led intensive care unit induction - an educational and quality improvement project. ICMx 3, A865 (2015). https://doi.org/10.1186/2197-425X-3-S1-A865

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  • DOI: https://doi.org/10.1186/2197-425X-3-S1-A865

Keywords

  • Intensive Care Medicine
  • Medical Background
  • Quality Improvement Project
  • Induction Programme
  • Patient Safety Issue