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Azoulay E, De Waele JJ, Cecconi M. Empowering excellence in intensive care: a vision for the European Society of Intensive Care Medicine. Intensive Care Med 2024; 50:1129-1132. [PMID: 38829530 DOI: 10.1007/s00134-024-07484-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 05/06/2024] [Indexed: 06/05/2024]
Affiliation(s)
- Elie Azoulay
- Critical Care Department, APHP, Hôpital Saint-Louis, Paris Cité University, 1 Avenue Claude Vellefaux, 75010, Paris, France.
| | - Jan J De Waele
- Department of Intensive Care Medicine, Ghent University Hospital, Ghent, Belgium
- Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Maurizio Cecconi
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Department of Anaesthesia and Intensive Care, IRCCS Humanitas Research Hospital, Milan, Italy
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Scholte JBJ, Strehler JC, Dill T, van Mook WNKA. Trainee-supervisor collaboration, progress-visualisation, and coaching: a survey on challenges in assessment of ICU trainees. BMC MEDICAL EDUCATION 2024; 24:120. [PMID: 38321516 PMCID: PMC10848472 DOI: 10.1186/s12909-023-04980-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 12/14/2023] [Indexed: 02/08/2024]
Abstract
BACKGROUND Assessing trainees is crucial for development of their competence, yet it remains a challenging endeavour. Identifying contributing and influencing factors affecting this process is imperative for improvement. METHODS We surveyed residents, fellows, and intensivists working in an intensive care unit (ICU) at a large non-university hospital in Switzerland to investigate the challenges in assessing ICU trainees. Thematic analysis revealed three major themes. RESULTS Among 45 physicians, 37(82%) responded. The first theme identified is trainee-intensivist collaboration discontinuity. The limited duration of trainees' ICU rotations, large team size operating in a discordant three-shift system, and busy and unpredictable day-planning hinder sustained collaboration. Potential solutions include a concise pre-collaboration briefing, shared bedside care, and post-collaboration debriefing involving formative assessment and reflection on collaboration. The second theme is the lack of trainees' progress visualisation, which is caused by unsatisfactory familiarisation with the trainees' development. The lack of an overview of a trainee's previous achievements, activities, strengths, weaknesses, and goals may result in inappropriate assessments. Participants suggested implementing digital assessment tools, a competence committee, and dashboards to facilitate progress visualisation. The third theme we identified is insufficient coaching and feedback. Factors like personality traits, hierarchy, and competing interests can impede coaching, while high-quality feedback is essential for correct assessment. Skilled coaches can define short-term goals and may optimise trainee assessment by seeking feedback from multiple supervisors and assisting in both formative and summative assessment. Based on these three themes and the suggested solutions, we developed the acronym "ICU-STAR" representing a potentially powerful framework to enhance short-term trainee-supervisor collaboration in the workplace and to co-scaffold the principles of adequate assessment. CONCLUSIONS According to ICU physicians, trainee-supervisor collaboration discontinuity, the lack of visualisation of trainee's development, and insufficient coaching and feedback skills of supervisors are the major factors hampering trainees' assessment in the workplace. Based on suggestions by the survey participants, we propose the acronym "ICU-STAR" as a framework including briefing, shared bedside care, and debriefing of the trainee-supervisor collaboration at the workplace as its core components. With the attending intensivists acting as coaches, progress visualisation can be enhanced by actively collecting more data points. TRIAL REGISTRATION N/A.
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Affiliation(s)
- Johannes B J Scholte
- Department of Intensive Care Medicine, Cantonal Hospital Lucerne, Lucerne, Switzerland.
- Master of Medical Education Student, University of Bern, Bern, Switzerland.
| | - Johannes C Strehler
- Department of Intensive Care Medicine, Cantonal Hospital Lucerne, Lucerne, Switzerland
| | - Tatjana Dill
- Master of Medical Education Student, University of Bern, Bern, Switzerland
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, Bern, Switzerland
- Swiss Air-Ambulance Ltd, Rega, Zurich, Switzerland
| | - Walther N K A van Mook
- Department of Intensive Care Medicine and Academy for Postgraduate Medical Training, Maastricht University Medical Centre, Maastricht, The Netherlands
- School of Health Professions Education, Maastricht University, Maastricht, The Netherlands
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Ashokka B, Ching Lee DW, Dong C. Twelve tips for developing a systematic acute care curriculum for medical students. MEDICAL TEACHER 2023; 45:17-24. [PMID: 34663178 DOI: 10.1080/0142159x.2021.1987405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
There are inadequacies in the practice-readiness of junior doctors for providing acute care in areas of clinical deterioration. In addition, the existing undergraduate curricula are fragmented in how acute care is taught in medical schools. We propose twelve tips for developing a systematic acute care curriculum, including what to teach, how to teach it and, how to assess. Furthermore, we propose and incorporate an acute care learning dashboard as an assessment tool which collates and demonstrates the occurrence of learning, faculty feedback, and students' reflection. We also summarise the existing online resources available for acute care training. We hope to address the existing issues and improve acute care training to prepare the graduates to become practice-ready professionals.
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Affiliation(s)
- Balakrishnan Ashokka
- Department of Anaesthesia, National University Health System, Singapore, Singapore
- Centre for Medical Education, CenMED, National University of Singapore, Singapore, Singapore
| | | | - Chaoyan Dong
- Education Office, Sengkang General Hospital, Singapore, Singapore
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Hasebrook JP, Michalak L, Kohnen D, Metelmann B, Metelmann C, Brinkrolf P, Flessa S, Hahnenkamp K. Digital transition in rural emergency medicine: Impact of job satisfaction and workload on communication and technology acceptance. PLoS One 2023; 18:e0280956. [PMID: 36693080 PMCID: PMC9873191 DOI: 10.1371/journal.pone.0280956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 01/11/2023] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Tele-emergency physicians (TEPs) take an increasingly important role in the need-oriented provision of emergency patient care. To improve emergency medicine in rural areas, we set up the project 'Rural|Rescue', which uses TEPs to restructure professional rescue services using information and communication technologies (ICTs) in order to reduce the therapy-free interval. Successful implementation of ICTs relies on user acceptance and knowledge sharing behavior. METHOD We conducted a factorial design with active knowledge transfer and technology acceptance as a function of work satisfaction (high vs. low), workload (high vs. low) and point in time (prior to vs. after digitalization). Data were collected via machine readable questionnaires issued to 755 persons (411 pre, 344 post), of which 304 or 40.3% of these persons responded (194 pre, 115 post). RESULTS Technology acceptance was higher after the implementation of TEP for nurses but not for other professions, and it was higher when the workload was high. Regarding active communication and knowledge sharing, employees with low work satisfaction are more likely to share their digital knowledge as compared to employees with high work satisfaction. This is an effect of previous knowledge concerning digitalization: After implementing the new technology, work satisfaction increased for the more experienced employees, but not for the less experienced ones. CONCLUSION Our research illustrates that employees' workload has an impact on the intention of using digital applications. The higher the workload, the more people are willing to use TEPs. Regarding active knowledge sharing, we see that employees with low work satisfaction are more likely to share their digital knowledge compared to employees with high work satisfaction. This might be attributed to the Dunning-Kruger effect. Highly knowledgeable employees initially feel uncertain about the change, which translates into temporarily lower work satisfaction. They feel the urge to fill even small knowledge gaps, which in return leads to higher work satisfaction. Those responsible need to acknowledge that digital change affects their employees' workflow and work satisfaction. During such times, employees need time and support to gather information and knowledge in order to cope with digitally changed tasks.
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Makris D, Tsolaki V, Robertson R, Dimopoulos G, Rello J. The future of training in intensive care medicine: A European perspective. JOURNAL OF INTENSIVE MEDICINE 2022; 3:52-61. [PMID: 36789360 PMCID: PMC9923960 DOI: 10.1016/j.jointm.2022.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/12/2022] [Accepted: 07/12/2022] [Indexed: 01/19/2023]
Affiliation(s)
| | | | - Ross Robertson
- Medical School, University of Thessaly, Larisa 41110, Greece
| | - George Dimopoulos
- Third Department of Critical Care, Medical School, National and Kapodistrian University of Athens, Athens 12462, Greece
| | - Jordi Rello
- CRIPS Department, Vall d'Hebron Institut of Research, Barcelona 08035, Spain,Clinical Research, CHU Nîmes, Nîmes 30029, France,Medical School, Universitat Internacional de Catalunya, Campus Sant Cugat, Sant Cugat del Valles, Barcelona 08195, Spain,Corresponding author: Jordi Rello, CRIPS Department, Vall d'Hebron Institut of Research, Barcelona 08035, Spain.
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Martín Delgado MC. Where is the future of the training of medical specialties heading? Med Intensiva 2022; 46:489-490. [PMID: 35810129 DOI: 10.1016/j.medine.2022.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 04/03/2022] [Indexed: 06/15/2023]
Affiliation(s)
- M C Martín Delgado
- Hospital Universitario de Torrejón, Universidad Francisco de Vitoria, Torrejón de Ardoz, Madrid, Spain.
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Castellanos-Ortega Á, Broch MJ, Palacios-Castañeda D, Gómez-Tello V, Valdivia M, Vicent C, Madrid I, Martinez N, Párraga MJ, Sancho E, Fuentes-Dura MDC, Sancerni-Beitia MD, García-Ros R. Competency assessment of residents of Intensive Care Medicine through a simulation-based objective structured clinical evaluation (OSCE). A multicenter observational study. Med Intensiva 2022; 46:491-500. [PMID: 36057440 DOI: 10.1016/j.medine.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 01/22/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES The current official model of training in Intensive Care Medicine (ICM) in Spain is based on exposure to experiences through clinical rotations. The main objective was to determine the level of competency (I novice to V independent practitioner) achieved by the residents at the end of the 3rd year of training (R3) in ICM through a simulation-based OSCE. Secondary objectives were: (1) To identify gaps in performance, and (2) To investigate the reliability and feasibility of conducting simulation-based assessment at multiple sites. DESIGN Observational multicenter study. SETTING Thirteen Spanish ICU Departments. PARTICIPANTS Thirty six R3. INTERVENTION The participants performed on five, 15-min, high-fidelity crisis scenarios in four simulation centers. The performances were video recorded for later scoring by trained raters. MAIN VARIABLES OF INTEREST Via a Delphi technique, an independent panel of expert intensivists identified critical essential performance elements (CEPE) for each scenario to define the levels of competency. RESULTS A total of 176 performances were analyzed. The internal consistency of the check-lists were adequate (KR-20 range 0.64-0.79). Inter-rater reliability was strong [median Intraclass Correlation Coefficient across scenarios: 0.89 (0.65-0.97)]. Competency levels achieved by R3 were: Level I (18.8%), II (35.2%), III (42.6%), IV/V (3.4%). Overall, a great heterogeneity in performance was observed. CONCLUSION The expected level of competency after one year in the ICU was achieved only in half of the performances. A more evidence-based educational approach is needed. Multiple center simulation-based assessment showed feasibility and reliability as an evaluation method of competency. TRIAL REGISTRATION COBALIDATION. NCT04278976. (https://register. CLINICALTRIALS gov).
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Affiliation(s)
- Á Castellanos-Ortega
- Intensive Care Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - M J Broch
- Intensive Care Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | - V Gómez-Tello
- Intensive Care Department, University Hospital Moncloa, Madrid, Spain
| | - M Valdivia
- Intensive Care Department, Hospital Puerta de Hierro-Majadahonda, Spain
| | - C Vicent
- Intensive Care Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - I Madrid
- Intensive Care Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - N Martinez
- Intensive Care Department, Hospital Puerta de Hierro-Majadahonda, Spain
| | - M J Párraga
- Intensive Care Department, Hospital Universitario Morales Meseguer, Murcia, Spain
| | - E Sancho
- Intensive Care Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - M D C Fuentes-Dura
- Department of Methodology of the Behavioral Sciences, University of Valencia, Spain
| | - M D Sancerni-Beitia
- Department of Methodology of the Behavioral Sciences, University of Valencia, Spain
| | - R García-Ros
- Department of Developmental and Educational Psychology, University of Valencia, Spain.
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Póvoa P, Martin-Loeches I, Duska F. Updated competency-based training in intensive care: next step towards a healthcare union in Europe? Intensive Care Med 2022; 48:1093-1094. [PMID: 35715645 DOI: 10.1007/s00134-022-06783-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Pedro Póvoa
- NOVA Medical School, CHRC, New University of Lisbon, Campo dos Mártires da Pátria, 130, 1169-056, Lisbon, Portugal. .,Center for Clinical Epidemiology and Research Unit of Clinical Epidemiology, OUH Odense University Hospital, Odense, Denmark. .,Polyvalent Intensive Care Unit, Hospital de São Francisco Xavier, CHLO, Lisbon, Portugal.
| | - Ignacio Martin-Loeches
- Department of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization (MICRO), St. James's Hospital, Dublin, Ireland.,Hospital Clinic, IDIBAPS, Universidad de Barcelona, Ciberes, Barcelona, Spain
| | - Frantisek Duska
- Charles University, Third Faculty of Medicine, Prague, Czech Republic.,Department of Intensive Care Medicine, FNKV University Hospital, Prague, Czech Republic
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10
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Castellanos-Ortega Á, Broch M, Palacios-Castañeda D, Gómez-Tello V, Valdivia M, Vicent C, Madrid I, Martinez N, Párraga M, Sancho E, Fuentes-Dura M, Sancerni-Beitia M, García-Ros R. Competency assessment of residents of Intensive Care Medicine through a simulation-based objective structured clinical evaluation (OSCE). A multicenter observational study. Med Intensiva 2022. [DOI: 10.1016/j.medin.2022.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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11
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Castellanos-Ortega A, Broch M, Barrios M, Fuentes-Dura M, Sancerni-Beitia M, Vicent C, Gimeno R, Ramírez P, Pérez F, García-Ros R. Análisis de la aceptación y validez de los métodos utilizados para la implementación de un programa de formación basado en competencias en un servicio de Medicina Intensiva de un hospital universitario de referencia. Med Intensiva 2021. [DOI: 10.1016/j.medin.2019.12.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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12
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Castellanos-Ortega A, Broch MJ, Barrios M, Fuentes-Dura MC, Sancerni-Beitia MD, Vicent C, Gimeno R, Ramírez P, Pérez F, García-Ros R. Acceptance and validity of the methods used to implement a competency based medical education programme in an Intensive Care Department of a teaching referral center. Med Intensiva 2021; 45:411-420. [PMID: 34563341 DOI: 10.1016/j.medine.2019.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 12/02/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVES 1. To determine the satisfaction of tutors and residents with a specific methodology used to implement CoBaTrICE. 2. To determine the reliability and validity of the global rating scales designed ad hoc to assess the performance of the residents for training purposes. DESIGN Prospective cohort study. PARTICIPANTS All the residents and tutors of the ICU Department of the Hospital Universitario y Politécnico la Fe de Valencia. INTERVENTION CoBaTrICE implementation started in March 2016, it was based on: (1) Training the tutors in feedback techniques; (2) Performing multiple objective and structured work based assessments to achieve the competences of the program; and (3) The use of an electronic portfolio to promote learning reflection and to collect the evidence that learning was taking place. METHODS The acceptance of CoBaTrICE was explored through a satisfaction survey conducted after 9 months of implementation of the training program. The 15 residents and 5 tutors of the ICU Department were asked about the methodology of the formative assessments, the quality of the feedback, self-learning regulation and the electronic portfolio usefulness. The validity of the global rating scales was assessed through the tests alfa de Cronbach, reliability and generalizability indexes, and intraclass correlation coefficient. RESULTS The implementation of CoBaTrICE was satisfactory in all the dimensions studied. The global rating scales used for formative purposes showed reliability and validity. CONCLUSIONS The methodology used to implement CoBaTrICE was highly valued by tutors and residents. The global rating scales used for formative purposes showed reliability and validity.
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Affiliation(s)
- A Castellanos-Ortega
- Servicio de Medicina Intensiva, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - M J Broch
- Servicio de Medicina Intensiva, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - M Barrios
- Servicio de Medicina Intensiva, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - M C Fuentes-Dura
- Departamento de Metodología de Ciencias del Comportamiento, Universidad de Valencia, Valencia, Spain
| | - M D Sancerni-Beitia
- Departamento de Metodología de Ciencias del Comportamiento, Universidad de Valencia, Valencia, Spain
| | - C Vicent
- Servicio de Medicina Intensiva, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - R Gimeno
- Servicio de Medicina Intensiva, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - P Ramírez
- Servicio de Medicina Intensiva, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - F Pérez
- Servicio de Medicina Intensiva, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - R García-Ros
- Departamento de Psicología Evolutiva y de la Educación, Universidad de Valencia, Valencia, Spain.
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Society of Critical Care Medicine 50th Anniversary Review Series: Critical Care Education. Crit Care Med 2021; 49:1241-1253. [PMID: 34261924 DOI: 10.1097/ccm.0000000000005130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cecconi M, Kesecioglu J, Azoulay E. Diversity and inclusivity: the way to multidisciplinary intensive care medicine in Europe. Intensive Care Med 2021; 47:598-601. [PMID: 33914111 PMCID: PMC8082476 DOI: 10.1007/s00134-021-06384-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 03/12/2021] [Indexed: 01/05/2023]
Affiliation(s)
- Maurizio Cecconi
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele - Milan, Italy. .,IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano - Milan, Italy.
| | - Jozef Kesecioglu
- Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Elie Azoulay
- Médecine Intensive et Réanimation, PHP, Hôpital Saint-Louis, Paris University, Paris, France
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Kerlin MP, Costa DK, Kahn JM. The Society of Critical Care Medicine at 50 Years: ICU Organization and Management. Crit Care Med 2021; 49:391-405. [PMID: 33555776 DOI: 10.1097/ccm.0000000000004830] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Meeta Prasad Kerlin
- Division of Pulmonary, Allergy, and Critical Care Medicine and Palliative and Advanced Illness Research Center, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Leonard Davis Institute, University of Pennsylvania, Philadelphia, PA
| | - Deena Kelly Costa
- Department of Systems, Populations and Leadership, University of Michigan School of Nursing, Ann Arbor, MI
- Institute for Healthcare Innovation & Policy, University of Michigan, Ann Arbor, MI
| | - Jeremy M Kahn
- Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
- Department of Health Policy & Management, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA
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Giuliani M, Martimianakis MA(T, Broadhurst M, Papadakos J, Fazelzad R, Driessen EW, Frambach J. Motivations for and Challenges in the Development of Global Medical Curricula: A Scoping Review. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:449-459. [PMID: 32271225 PMCID: PMC7899747 DOI: 10.1097/acm.0000000000003383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
PURPOSE The aim of this scoping review is to understand the motivations for the creation of global medical curricula, summarize methods that have been used to create these curricula, and understand the perceived premises for the creation of these curricula. METHOD In 2018, the authors used a comprehensive search strategy to identify papers on existing efforts to create global medical curricula published from 1998 to March 29, 2018, in the following databases: MEDLINE; MEDLINE Epub Ahead of Print, In-Process, and Other Non-Indexed Citations; Embase; Cochrane Central Register of Controlled Trials; Cochrane Database of Systematic Reviews; PsycINFO; CINAHL; ERIC; Scopus; African Index Medicus; and LILACS. There were no language restrictions. Two independent researchers applied the inclusion and exclusion criteria. Demographic data were abstracted from publications and summarized. The stated purposes, methods used for the development, stated motivations, and reported challenges of curricula were coded. RESULTS Of the 18,684 publications initially identified, 137 met inclusion criteria. The most common stated purposes for creating curricula were to define speciality-specific standards (50, 30%), to harmonize training standards (38, 23%), and to improve the quality or safety of training (31, 19%). The most common challenges were intercountry variation (including differences in health care systems, the operationalization of medical training, and sociocultural differences; 27, 20%), curricular implementation (20, 15%), and the need for a multistakeholder approach (6, 4%). Most curricula were developed by a social group (e.g., committee; 30, 45%) or Delphi or modified Delphi process (22, 33%). CONCLUSIONS The challenges of intercountry variation, the need for a multistakeholder approach, and curricular implementation need to be considered if concerns about curricular relevance are to be addressed. These challenges undoubtedly impact the uptake of global medical curricula and can only be addressed by explicit efforts to make curricula applicable to the realities of diverse health care settings.
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Affiliation(s)
- Meredith Giuliani
- M. Giuliani is staff radiation oncologist and medical director, Cancer Education Program, Princess Margaret Cancer Centre, and associate professor, Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada; ORCID: https://orcid.org/0000-0003-1827-5590
| | - Maria Athina (Tina) Martimianakis
- M.A. Martimianakis is associate professor and director of medical education scholarship, Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada; ORCID: https://orcid.org/0000-0002-2531-3156
| | - Michaela Broadhurst
- M. Broadhurst is research analyst, Cancer Education Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Janet Papadakos
- J. Papadakos is codirector, Cancer Health Literacy Research Centre, Cancer Education Program, Princess Margaret Cancer Centre, and assistant professor, Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada; ORCID: https://orcid.org/0000-0001-6320-4156
| | - Rouhi Fazelzad
- R. Fazelzad is information specialist, Library and Information Services, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Erik W. Driessen
- E.W. Driessen is professor and chair, Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; ORCID: https://orcid.org/0000-0001-8115-261X
| | - Janneke Frambach
- J. Frambach is assistant professor, School of Health Professions Education, Maastricht University, Maastricht, the Netherlands; ORCID: https://orcid.org/0000-0003-1527-6539
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Pedreros C. Competencias y habilidades del médico en cuidados críticos en Chile. REVISTA MÉDICA CLÍNICA LAS CONDES 2019. [DOI: 10.1016/j.rmclc.2018.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Edwards Z, Lucas DN, Gauntlett R. Is training in obstetric critical care adequate? An international comparison. Int J Obstet Anesth 2018; 37:96-105. [PMID: 30482716 DOI: 10.1016/j.ijoa.2018.08.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 07/17/2018] [Accepted: 08/29/2018] [Indexed: 01/18/2023]
Abstract
Obstetric critical care is an emerging discipline which cuts across speciality boundaries. We have analysed the training curricula in the three major specialities (obstetrics, anaesthesia and intensive care medicine) likely to be involved in the care of the critically-ill obstetric patient, to assess whether it is adequate to ensure effective training on this subject.
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Affiliation(s)
- Z Edwards
- Department of Anaesthetics, Northwick Park Hospital, Harrow, United Kingdom.
| | - D N Lucas
- Department of Anaesthetics, Northwick Park Hospital, Harrow, United Kingdom
| | - R Gauntlett
- Department of Anaesthetics, Royal Victoria Infirmary, Newcastle, United Kingdom
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Ball L, Riforgiato C, Pelosi P. Intensive Care Medicine: Different Recipes for Shared Goals. Turk J Anaesthesiol Reanim 2017; 45:327-328. [PMID: 29359069 PMCID: PMC5772409 DOI: 10.5152/tjar.2017.251101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Affiliation(s)
| | | | - Paolo Pelosi
- Address for Correspondence: Professor Paolo Pelosi, E-mail:
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Ball L, Riforgiato C, Pelosi P. Educational and Training Programs in Intensive Care Medicine are the Right Way. Turk J Anaesthesiol Reanim 2017; 45:247-248. [PMID: 29114406 DOI: 10.5152/tjar.2017.200902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Lorenzo Ball
- IRCCS AOU San Martino-IST, Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy
| | - Chiara Riforgiato
- IRCCS AOU San Martino-IST, Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy
| | - Paolo Pelosi
- IRCCS AOU San Martino-IST, Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy
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Dijkstra IS, Brand PLP, Pols J, Delwig H, Jaarsma DADC, Tulleken JE. Are graduated intensivists prepared for practice? A case study from The Netherlands. J Crit Care 2017; 42:47-53. [PMID: 28679114 DOI: 10.1016/j.jcrc.2017.01.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 12/12/2016] [Accepted: 01/22/2017] [Indexed: 10/20/2022]
Abstract
PURPOSE An evaluation of the alignment between intensive care medicine (ICM) training and practice provides valuable information for the development of ICM training. Therefore this study examines how well recently licensed intensivists feel prepared for practice and whether intensivists from different background specialties attain comparable preparedness rates. METHODS An inventory was developed to cover the tasks that constitute ICM practice. Two hundred five recently licensed Dutch intensivists received a questionnaire in which they could indicate how well their ICM training programme prepared them for these tasks on a 5-point Likert scale. RESULTS Ninety-one respondents returned the questionnaire (response 45%). Respondents felt excellently prepared for 67 tasks, well prepared for 16 tasks, marginally sufficiently prepared for 6 tasks and insufficiently prepared for 15 tasks. Intensivists from anaesthesiology felt better prepared for IC specific activities (mean 4.25, SD 0.38) than those from internal medicine (mean 4.01, SD 0.40, P=.02).Average scores on tasks related to medical expertise were relatively high while tasks relating to management and leadership, science and professional development scored lower. CONCLUSIONS Although recently licensed intensivists are well prepared for most tasks in ICM, lower preparedness scores on tasks related to leadership and management, science, and professional development call for re-evaluation of the current curriculum.
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Affiliation(s)
- Ids S Dijkstra
- Wenckebach Institute, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Paul L P Brand
- Wenckebach Institute, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Princess Amalia Children's Centre, Isala Hospital, Zwolle, The Netherlands
| | - Jan Pols
- Center for Educational Development and Research in Health Professions, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Hans Delwig
- Department of Critical Care, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Debbie A D C Jaarsma
- Center for Educational Development and Research in Health Professions, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jaap E Tulleken
- Department of Critical Care, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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22
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Peng JM, Qian CY, Yu XY, Zhao MY, Li SS, Ma XC, Kang Y, Zhou FC, He ZY, Qin TH, Yin YJ, Jiang L, Hu ZJ, Sun RH, Lin JD, Li T, Wu DW, An YZ, Ai YH, Zhou LH, Cao XY, Zhang XJ, Sun RQ, Chen EZ, Du B. Does training improve diagnostic accuracy and inter-rater agreement in applying the Berlin radiographic definition of acute respiratory distress syndrome? A multicenter prospective study. Crit Care 2017; 21:12. [PMID: 28107822 PMCID: PMC5251343 DOI: 10.1186/s13054-017-1606-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 01/04/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Poor inter-rater reliability in chest radiograph interpretation has been reported in the context of acute respiratory distress syndrome (ARDS), although not for the Berlin definition of ARDS. We sought to examine the effect of training material on the accuracy and consistency of intensivists' chest radiograph interpretations for ARDS diagnosis. METHODS We conducted a rater agreement study in which 286 intensivists (residents 41.3%, junior attending physicians 35.3%, and senior attending physician 23.4%) independently reviewed the same 12 chest radiographs developed by the ARDS Definition Task Force ("the panel") before and after training. Radiographic diagnoses by the panel were classified into the consistent (n = 4), equivocal (n = 4), and inconsistent (n = 4) categories and were used as a reference. The 1.5-hour training course attended by all 286 intensivists included introduction of the diagnostic rationale, and a subsequent in-depth discussion to reach consensus for all 12 radiographs. RESULTS Overall diagnostic accuracy, which was defined as the percentage of chest radiographs that were interpreted correctly, improved but remained poor after training (42.0 ± 14.8% before training vs. 55.3 ± 23.4% after training, p < 0.001). Diagnostic sensitivity and specificity improved after training for all diagnostic categories (p < 0.001), with the exception of specificity for the equivocal category (p = 0.883). Diagnostic accuracy was higher for the consistent category than for the inconsistent and equivocal categories (p < 0.001). Comparisons of pre-training and post-training results revealed that inter-rater agreement was poor and did not improve after training, as assessed by overall agreement (0.450 ± 0.406 vs. 0.461 ± 0.575, p = 0.792), Fleiss's kappa (0.133 ± 0.575 vs. 0.178 ± 0.710, p = 0.405), and intraclass correlation coefficient (ICC; 0.219 vs. 0.276, p = 0.470). CONCLUSIONS The radiographic diagnostic accuracy and inter-rater agreement were poor when the Berlin radiographic definition was used, and were not significantly improved by the training set of chest radiographs developed by the ARDS Definition Task Force. TRIAL REGISTRATION The study was registered at ClinicalTrials.gov (registration number NCT01704066 ) on 6 October 2012.
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Affiliation(s)
- Jin-Min Peng
- Medical ICU, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing, 100730 People’s Republic of China
| | - Chuan-Yun Qian
- Department of Emergency Medicine, The First Affiliated Hospital of Kunming Medical University, 295 Xichang Street, Kunming, 650032 People’s Republic of China
| | - Xiang-You Yu
- Department of Critical Care Medicine, First Affiliated Hospital, Xinjiang Medical University, 1 Liyushan Road, Urumqi, 830054 People’s Republic of China
| | - Ming-Yan Zhao
- Department of Critical Care Medicine, The First Affiliated Hospital, Harbin Medical University, 23 Youzheng Street, Harbin, 150001 People’s Republic of China
| | - Shu-Sheng Li
- Department of Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, 1095 Jiefang Road, Wuhan, 430030 People’s Republic of China
| | - Xiao-Chun Ma
- Department of Critical Care Medicine, The First Affiliated Hospital of China Medical University, 155 North Nanjing Street, Shenyang, 110001 People’s Republic of China
| | - Yan Kang
- Department of Critical Care Medicine, West China Hospital, Sichuan University, 37 Guoxue Alley, Chengdu, 610041 People’s Republic of China
| | - Fa-Chun Zhou
- Department of Critical Care Medicine, The First Affiliated Hospital, Chongqing Medical University, 1 Youyi Road, Yuanjiagang, Chongqing, 400016 People’s Republic of China
| | - Zhen-Yang He
- Department of Critical Care Medicine, Hainan Provincial People’s Hospital, No. 19 Xiuhua Road, Haikou, 570311 People’s Republic of China
| | - Tie-He Qin
- Department of Critical Care Medicine, Guangdong General Hospital, 106 Zhongshan Er Road, Guangzhou, 510080 People’s Republic of China
| | - Yong-Jie Yin
- Department of Emergency and Critical Care Medicine, The Second Hospital of Jilin University, 18 Ziqiang Street, Changchun, 130041 People’s Republic of China
| | - Li Jiang
- Department of Critical Care Medicine, Fuxing Hospital, Capital Medical University, A20 Fuxingmenwai Street, Beijing, 100038 People’s Republic of China
| | - Zhen-Jie Hu
- Department of Critical Care Medicine, Hebei Medical University Fourth Hospital, 12 Jiankang Road, Shijiazhuang, 050011 People’s Republic of China
| | - Ren-Hua Sun
- Department of Critical Care Medicine, Zhejiang Provincial People’s Hospital, 158 Shangtang Road, Hangzhou, 310014 People’s Republic of China
| | - Jian-Dong Lin
- Department of Critical Care Medicine, The First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005 People’s Republic of China
| | - Tong Li
- Department of Critical Care Medicine, Beijing Tongren Hospital, Capital Medical University, 2 Chongwenmennei Street, Beijing, 100730 People’s Republic of China
| | - Da-Wei Wu
- Department of Critical Care Medicine, Qilu Hospital, Shandong University, 107 Wenhua Xi Road, Jinan, 250012 People’s Republic of China
| | - You-Zhong An
- Department of Critical Care Medicine, Peking University People’s Hospital, 11 Xizhimen South Street, Beijing, 100044 People’s Republic of China
| | - Yu-Hang Ai
- Department of Critical Care Medicine, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008 People’s Republic of China
| | - Li-Hua Zhou
- Department of Critical Care Medicine, The Affiliated Hospital of Inner Mongolia Medical College, 1 Tongdao North Street, Huhhot, 010050 People’s Republic of China
| | - Xiang-Yuan Cao
- Department of Critical Care Medicine, Affiliated Hospital of Ningxia Medical University, 804 Shengli South Street, Yinchuan, 750004 People’s Republic of China
| | - Xi-Jing Zhang
- Surgical ICU, Department of Anesthesia, Xijing Hospital, 127 Chang Le Xi Road, Xi’an, 710032 People’s Republic of China
| | - Rong-Qing Sun
- Surgical ICU, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Road, Zhengzhou, 450052 Henan People’s Republic of China
| | - Er-Zhen Chen
- Ruijin Hospital, Shanghai Jiao Tong University, No. 197 Ruijin Er Road, Shanghai, 200025 People’s Republic of China
| | - Bin Du
- Medical ICU, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing, 100730 People’s Republic of China
| | - for the China Critical Care Clinical Trial Group (CCCCTG)
- Medical ICU, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing, 100730 People’s Republic of China
- Department of Emergency Medicine, The First Affiliated Hospital of Kunming Medical University, 295 Xichang Street, Kunming, 650032 People’s Republic of China
- Department of Critical Care Medicine, First Affiliated Hospital, Xinjiang Medical University, 1 Liyushan Road, Urumqi, 830054 People’s Republic of China
- Department of Critical Care Medicine, The First Affiliated Hospital, Harbin Medical University, 23 Youzheng Street, Harbin, 150001 People’s Republic of China
- Department of Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, 1095 Jiefang Road, Wuhan, 430030 People’s Republic of China
- Department of Critical Care Medicine, The First Affiliated Hospital of China Medical University, 155 North Nanjing Street, Shenyang, 110001 People’s Republic of China
- Department of Critical Care Medicine, West China Hospital, Sichuan University, 37 Guoxue Alley, Chengdu, 610041 People’s Republic of China
- Department of Critical Care Medicine, The First Affiliated Hospital, Chongqing Medical University, 1 Youyi Road, Yuanjiagang, Chongqing, 400016 People’s Republic of China
- Department of Critical Care Medicine, Hainan Provincial People’s Hospital, No. 19 Xiuhua Road, Haikou, 570311 People’s Republic of China
- Department of Critical Care Medicine, Guangdong General Hospital, 106 Zhongshan Er Road, Guangzhou, 510080 People’s Republic of China
- Department of Emergency and Critical Care Medicine, The Second Hospital of Jilin University, 18 Ziqiang Street, Changchun, 130041 People’s Republic of China
- Department of Critical Care Medicine, Fuxing Hospital, Capital Medical University, A20 Fuxingmenwai Street, Beijing, 100038 People’s Republic of China
- Department of Critical Care Medicine, Hebei Medical University Fourth Hospital, 12 Jiankang Road, Shijiazhuang, 050011 People’s Republic of China
- Department of Critical Care Medicine, Zhejiang Provincial People’s Hospital, 158 Shangtang Road, Hangzhou, 310014 People’s Republic of China
- Department of Critical Care Medicine, The First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005 People’s Republic of China
- Department of Critical Care Medicine, Beijing Tongren Hospital, Capital Medical University, 2 Chongwenmennei Street, Beijing, 100730 People’s Republic of China
- Department of Critical Care Medicine, Qilu Hospital, Shandong University, 107 Wenhua Xi Road, Jinan, 250012 People’s Republic of China
- Department of Critical Care Medicine, Peking University People’s Hospital, 11 Xizhimen South Street, Beijing, 100044 People’s Republic of China
- Department of Critical Care Medicine, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008 People’s Republic of China
- Department of Critical Care Medicine, The Affiliated Hospital of Inner Mongolia Medical College, 1 Tongdao North Street, Huhhot, 010050 People’s Republic of China
- Department of Critical Care Medicine, Affiliated Hospital of Ningxia Medical University, 804 Shengli South Street, Yinchuan, 750004 People’s Republic of China
- Surgical ICU, Department of Anesthesia, Xijing Hospital, 127 Chang Le Xi Road, Xi’an, 710032 People’s Republic of China
- Surgical ICU, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Road, Zhengzhou, 450052 Henan People’s Republic of China
- Ruijin Hospital, Shanghai Jiao Tong University, No. 197 Ruijin Er Road, Shanghai, 200025 People’s Republic of China
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Humphrey-Murto S, Varpio L, Gonsalves C, Wood TJ. Using consensus group methods such as Delphi and Nominal Group in medical education research . MEDICAL TEACHER 2017; 39:14-19. [PMID: 27841062 DOI: 10.1080/0142159x.2017.1245856] [Citation(s) in RCA: 223] [Impact Index Per Article: 31.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Consensus group methods are widely used in research to identify and measure areas where incomplete evidence exists for decision-making. Despite their widespread use, these methods are often inconsistently used and reported. Using examples from the three most commonly used methods, the Delphi, Nominal Group and RAND/UCLA; this paper and associated Guide aim to describe these methods and to highlight common weaknesses in methodology and reporting. The paper outlines a series of recommendations to assist researchers using consensus group methods in providing a comprehensive description and justification of the steps taken in their study.
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Affiliation(s)
| | - Lara Varpio
- b School of Medicine , Uniformed Services University of the Health Sciences , Bethesda , MD , USA
| | - Carol Gonsalves
- a Division of Rheumatology , University of Ottawa , Ottawa , Canada
| | - Timothy J Wood
- a Division of Rheumatology , University of Ottawa , Ottawa , Canada
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Hu X, Xi X, Ma P, Qiu H, Yu K, Tang Y, Qian C, Fang Q, Wang Y, Yu X, Xu Y, Du B. Consensus development of core competencies in intensive and critical care medicine training in China. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2016; 20:330. [PMID: 27743557 PMCID: PMC5065915 DOI: 10.1186/s13054-016-1514-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 09/27/2016] [Indexed: 01/05/2023]
Abstract
Background The aim of this study is to develop consensus on core competencies required for postgraduate training in intensive care medicine. Methods We used a combination of a modified Delphi method and a nominal group technique to create and modify the list of core competencies to ensure maximum consensus. Ideas were generated modified from Competency Based Training in Intensive Care Medicine in Europe collaboration (CoBaTrICE) core competencies. An online survey invited healthcare professionals, educators, and trainees to rate and comment on these competencies. The output from the online survey was edited and then reviewed by a nominal group of 13 intensive care professionals to identify each competence for importance. The resulting list was then recirculated in the nominal group for iterative rating. Results The online survey yielded a list of 199 competencies for nominal group reviewing. After five rounds of rating, 129 competencies entered the final set defined as core competencies. Conclusions We have generated a set of core competencies using a consensus technique which can serve as an indicator for training program development. Electronic supplementary material The online version of this article (doi:10.1186/s13054-016-1514-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Xiaoyun Hu
- Medical Intensive Care Unit, Peking Union Medicine Collage Hospital, 1 Shuai Fu Yuan, Beijing, 100730, China
| | - Xiuming Xi
- Department of Critical Care Medicine, Fuxing Hospital, Capital Medical University, Beijing, China
| | - Penglin Ma
- Department of Emergency and Critical Care Medicine, People's Liberation Army 309 Hospital, Beijing, China
| | - Haibo Qiu
- Department of Emergency and Critical Care Medicine, Zhongda Hospital, Southeast University, Nanjing, Jiangsu Province, China
| | - Kaijiang Yu
- Department of Critical Care Medicine, Haerbin Medical University Third Hospital, Haerbin, Heilongjiang Province, China
| | - Yaoqing Tang
- Department of Critical Care Medicine, RuiJin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Chuanyun Qian
- Department of Emergency and Critical Care Medicine, Kunming Medical University 1st Hospital, Kunming, Yunnan Province, China
| | - Qiang Fang
- Department of Critical Care Medicine, Zhejiang University 1st Hospital, Hangzhou, Zhejiang Province, China
| | - Yushan Wang
- Department of Critical Care Medicine, Jilin University 1st Hospital, Changchun, Jilin Province, China
| | - Xiangyou Yu
- Department of Critical Care Medicine, Xinjiang Medical University 1st Hospital, Urumuqi, Xinjiang, China
| | - Yuan Xu
- Department of Critical Care Medicine, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, China
| | - Bin Du
- Medical Intensive Care Unit, Peking Union Medicine Collage Hospital, 1 Shuai Fu Yuan, Beijing, 100730, China.
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Amin P, Fox-Robichaud A, Divatia JV, Pelosi P, Altintas D, Eryüksel E, Mehta Y, Suh GY, Blanch L, Weiler N, Zimmerman J, Vincent JL. The Intensive care unit specialist: Report from the Task Force of World Federation of Societies of Intensive and Critical Care Medicine. J Crit Care 2016; 35:223-8. [PMID: 27444985 DOI: 10.1016/j.jcrc.2016.06.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 06/12/2016] [Indexed: 01/24/2023]
Abstract
The role of the critical care specialist has been unequivocally established in the management of severely ill patients throughout the world. Data show that the presence of a critical care specialist in the intensive care unit (ICU) environment has reduced morbidity and mortality, improved patient safety, and reduced length of stay and costs. However, many ICUs across the world function as "open ICUs," in which patients may be admitted under a primary physician who has not been trained in critical care medicine. Although the concept of the ICU has gained widespread acceptance amongst medical professionals, hospital administrators and the general public; recognition and the need for doctors specializing in intensive care medicine has lagged behind. The curriculum to ensure appropriate training around the world is diverse but should ideally meet some minimum standards. The World Federation of Societies of Intensive and Critical Care Medicine has set up a task force to address issues concerning the training, functions, roles, and responsibilities of an ICU specialist.
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Affiliation(s)
- Pravin Amin
- Bombay Hospital Institute of Medical Sciences, Mumbai, India.
| | | | | | | | | | | | | | - Gee Young Suh
- Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Lluís Blanch
- Universitat Autònoma de Barcelona, CIBERes, Parc Taulí Hospital, Sabadell, Spain
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Shime N. Clinical and investigative critical care medicine in Japan. Intensive Care Med 2016; 42:453-455. [DOI: 10.1007/s00134-015-4165-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 11/20/2015] [Indexed: 12/27/2022]
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Divatia JV, Iyer S. Ten major priorities for intensive care in India. Intensive Care Med 2015; 41:1468-71. [PMID: 25573499 DOI: 10.1007/s00134-014-3618-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 12/13/2014] [Indexed: 12/14/2022]
Affiliation(s)
- J V Divatia
- Department of Anaesthesia, Critical Care and Pain, Tata Memorial Hospital, Dr. E. Borges Marg, Parel, Mumbai, 40012, India,
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Castellanos-Ortega A, Rothen HU, Franco N, Rayo LA, Martín-Loeches I, Ramírez P, Cuñat de la Hoz J. Training in intensive care medicine. A challenge within reach. Med Intensiva 2014; 38:305-10. [PMID: 24589154 DOI: 10.1016/j.medin.2013.12.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 12/30/2013] [Indexed: 11/30/2022]
Abstract
The medical training model is currently immersed in a process of change. The new paradigm is intended to be more effective, more integrated within the healthcare system, and strongly oriented towards the direct application of knowledge to clinical practice. Compared with the established training system based on certification of the completion of a series or rotations and stays in certain healthcare units, the new model proposes a more structured training process based on the gradual acquisition of specific competences, in which residents must play an active role in designing their own training program. Training based on competences guarantees more transparent, updated and homogeneous learning of objective quality, and which can be homologated internationally. The tutors play a key role as the main directors of the process, and institutional commitment to their work is crucial. In this context, tutors should receive time and specific formation to allow the evaluation of training as the cornerstone of the new model. New forms of objective summative and training evaluation should be introduced to guarantee that the predefined competences and skills are effectively acquired. The free movement of specialists within Europe is very desirable and implies that training quality must be high and amenable to homologation among the different countries. The Competency Based training in Intensive Care Medicine in Europe program is our main reference for achieving this goal. Scientific societies in turn must impulse and facilitate all those initiatives destined to improve healthcare quality and therefore specialist training. They have the mission of designing strategies and processes that favor training, accreditation and advisory activities with the government authorities.
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Affiliation(s)
- A Castellanos-Ortega
- Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, España.
| | - H U Rothen
- Department of Intensive Care Medicine, University Hospital of Bern, Berna, Suiza
| | - N Franco
- Servicio de Medicina Intensiva, Hospital Universitario de Móstoles, Móstoles, Madrid, España
| | - L A Rayo
- Servicio de Medicina Intensiva, Hospital Son Espases, Palma de Mallorca, España
| | - I Martín-Loeches
- Servicio de Medicina Intensiva, Hospital de Sabadell, Corporació Sanitària Universitària Parc Taulí, Sabadell, Barcelona, España
| | - P Ramírez
- Servicio de Medicina Intensiva, Hospital La Fe, Valencia, España
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Bion J, Rothen HU. Models for Intensive Care Training. A European Perspective. Am J Respir Crit Care Med 2014; 189:256-62. [DOI: 10.1164/rccm.201311-2058cp] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Quality improvement of interdisciplinary rounds by leadership training based on essential quality indicators of the Interdisciplinary Rounds Assessment Scale. Intensive Care Med 2013; 39:1800-7. [DOI: 10.1007/s00134-013-3002-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 06/10/2013] [Indexed: 11/25/2022]
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Blanch L, Annane D, Antonelli M, Chiche JD, Cuñat J, Girard TD, Jiménez EJ, Quintel M, Ugarte S, Mancebo J. The future of intensive care medicine. Med Intensiva 2013; 37:91-8. [PMID: 23398846 DOI: 10.1016/j.medin.2012.12.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Accepted: 12/19/2012] [Indexed: 02/04/2023]
Abstract
Intensive care medical training, whether as a primary specialty or as secondary add-on training, should include key competences to ensure a uniform standard of care, and the number of intensive care physicians needs to increase to keep pace with the growing and anticipated need. The organisation of intensive care in multiple specialty or central units is heterogeneous and evolving, but appropriate early treatment and access to a trained intensivist should be assured at all times, and intensivists should play a pivotal role in ensuring communication and high-quality care across hospital departments. Structures now exist to support clinical research in intensive care medicine, which should become part of routine patient management. However, more translational research is urgently needed to identify areas that show clinical promise and to apply research principles to the real-life clinical setting. Likewise, electronic networks can be used to share expertise and support research. Individuals, physicians and policy makers need to allow for individual choices and priorities in the management of critically ill patients while remaining within the limits of economic reality. Professional scientific societies play a pivotal role in supporting the establishment of a defined minimum level of intensive health care and in ensuring standardised levels of training and patient care by promoting interaction between physicians and policy makers. The perception of intensive care medicine among the general public could be improved by concerted efforts to increase awareness of the services provided and of the successes achieved.
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Affiliation(s)
- L Blanch
- Critical Care Center, Hospital de Sabadell, Corporacio Sanitaria Universitària Parc Taulí, Sabadell, Spain.
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Mancebo J, Hall J. Is the Doctor In? Views on the Deployment of Intensivists from Both Sides of the Atlantic. Am J Respir Crit Care Med 2012; 185:696-7. [DOI: 10.1164/rccm.201201-0149ed] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Year in review in Intensive Care Medicine 2011. II. Cardiovascular, infections, pneumonia and sepsis, critical care organization and outcome, education, ultrasonography, metabolism and coagulation. Intensive Care Med 2012; 38:345-58. [PMID: 22270471 PMCID: PMC3291826 DOI: 10.1007/s00134-012-2467-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2012] [Accepted: 01/02/2012] [Indexed: 12/14/2022]
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Improving the quality of training programs in intensive care: a view from the ESICM. Intensive Care Med 2011; 37:377-9. [PMID: 21234746 DOI: 10.1007/s00134-010-2120-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2010] [Accepted: 11/28/2010] [Indexed: 12/11/2022]
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Year in review in Intensive Care Medicine 2010: II. Pneumonia and infections, cardiovascular and haemodynamics, organization, education, haematology, nutrition, ethics and miscellanea. Intensive Care Med 2011; 37:196-213. [PMID: 21225240 PMCID: PMC3029678 DOI: 10.1007/s00134-010-2123-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2010] [Accepted: 12/27/2010] [Indexed: 12/14/2022]
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