New Tech for Old Challenges: Jr Resident Education in the ICU Houman Khosravani
Solutions not answers
The truth is, we have outrun an educational system framed in simpler days and for simpler conditions.
–Sir William Osler, 1913, St. George’s Hospital Medical School, London
Current Challenges Facing Resident Education in the ICU Diverse backgrounds Acute situations = anxiety Time! “busy rotation” Engagement / participation - tacit knowledge Dyssynchrony - teaching vs. clinical schedules
Current “Answers” THE orientation email! Introduction/Orientation talk Handouts/slides Seminars
Objectives Early, pre-rotation delivery of orientation material App-/web-based content delivery “Anxiolysis” - teach the “ABCs of survival” topics Continued education during the rotation Track progress Two-way Communication
Method: Survey of Educational Needs Google Apps for Education Survey of Consultants, Fellows, Residents across 2 blocks, 2 sites ad-hoc discussions N=14 respondents (3 consultants, 2 fellows, 9 residents, mostly PGY2; ~40% of surveyed) 27 Topics (e.g. pressors, airway management)
Would they use it?
93% - stated, beneficial to have pre-rotation pod/ vodcasts 100% - stated would use them
Number of Requests (per topic)
N=14 respondents 12
9
6
3
0
Topics (27 items)
Introduction to airway management Sepsis & vasoactive agents Vascular Access
Orientation / Getting things done Sedation & Analgesia
80% Utilized 10% Did not utilize/Not available 10% “Could not access”
N=36
Number of Residents
Post-rotation Survey - Hours of educational material usage
Self-reported duration of use (hrs)
33% 2 hrs 22% 3 hrs 11% 5 hrs
More Teaching from fellows? More Teaching from staff? More Scheduled classroom/lecture-based teaching? More Podcasts or online resources? More Patients encounters? Different patient presentations? More on family meetings/ethics? More procedural teaching? I want MORE of all the above! I want LESS teaching! N=36, resident respondents
Number of requests
50% - More teaching by fellows/consultants 30% - More online resources/advanced courses
Post-rotation Survey Future Topics?
Vasopressors Vents. - IV NIV ID in the ICU Acid/Base STEMI/NSTEMI
Conclusions Cloud platform: Asynchronous learning - adult learning model No wasted lectures! Flipped Classroom = anxiolysis Why not just a website? Already existing platforms? Progressive/real-time evaluation Residents still want didactic teaching Technology barriers to exist
New Tech for old Challenges - ICU Education - eCriticalCare ver04.pdf
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