Development of critical care medicine in India

Communication Skill Training Levels among Critical Care Doctors in India

Medical training programs outline the necessity of communication skills but there is likely a dearth of teaching at the bedside in part due to prioritization of other skills over communication or due to lack of opportunity. In India, the majority of critical care units are open in nature, and communication lead is likely to be taken by the primary specialty rather than the critical care doctors themselves. In the majority of the cases, the root cause analysis shows a lack of clear communication as a barrier. The sicker the patient, the higher the chance for anxiety and miscommunication among healthcare professionals as well as the family. The current project aims to find the training levels in Indian critical care settings and draw conclusions to see if there are avenues to improve the process. This study was based on a web-based questionnaire that was sent out to 1,000 critical care doctors across India. Educational experience and learning of communication techniques/concepts were assessed using a modified educational experience and attitudes questionnaire. Baseline demographic data were obtained and results were tabulated across 193 complete responses, which consistently showed a disparity in perceived levels of competence across different mandatory aspects of communication. Further, we find that though communication is a trainable skill, the mode of training has been largely reactive and has remained so for the last 20 years hinting at poor training in communication. Our survey suggests an urgent need for improvement of the training processes to reduce the burden of ethical, clinical, and legal dilemmas in critical care.

How to cite this article

Gopaldas JA, Narayanaswamy N, Chandregowda NP. Communication Skill Training Levels among Critical Care Doctors in India. Indian J Crit Care Med 2023;27(8):567-571.

ISCCM Guidelines for Hemodynamic Monitoring in the Critically Ill

Hemodynamic assessment along with continuous monitoring and appropriate therapy forms an integral part of management of critically ill patients with acute circulatory failure. In India, the infrastructure in ICUs varies from very basic facilities in smaller towns and semi-urban areas, to world-class, cutting-edge technology in corporate hospitals, in metropolitan cities. Surveys and studies from India suggest a wide variation in clinical practices due to possible lack of awareness, expertise, high costs, and lack of availability of advanced hemodynamic monitoring devices. We, therefore, on behalf of the Indian Society of Critical Care Medicine (ISCCM), formulated these evidence-based guidelines for optimal use of various hemodynamic monitoring modalities keeping in mind the resource-limited settings and the specific needs of our patients. When enough evidence was not forthcoming, we have made recommendations after achieving consensus amongst members. Careful integration of clinical assessment and critical information obtained from laboratory data and monitoring devices should help in improving outcomes of our patients.

How to cite this article

Kulkarni AP, Govil D, Samavedam S, Srinivasan S, Ramasubban S, Venkataraman R, et al. ISCCM Guidelines for Hemodynamic Monitoring in the Critically Ill. Indian J Crit Care Med 2022;26(S2):S66-S76.

Memores Acti Prudentes Future!

How to cite this article: Kulkarni AP, Govil D. Memores Acti Prudentes Future! Indian J Crit Care Med 2022;26(1):1.

Training and Delivery of Critical Care Medicine in India: Concerns Revealed by COVID-19 Pandemic

How to cite this article: Ozair A, Agrawal A, Siddiqui SS. Training and Delivery of Critical Care Medicine in India: Concerns Revealed by COVID-19 Pandemic. Indian J Crit Care Med 2020;24(4):285-286.