Knowledge and Competence Towards Critical Care Concepts Among Final Year Medical Students and Interns: A Cross-Sectional Study

PURPOSE

Critical care knowledge constitutes an essential component in medicine. Unfortunately, ICU knowledge acquisition is limited in many medical schools. This study is intended to measure the knowledge background, gaps, and the confidence toward critical care concepts among final year medical students and interns at Umm Al-Qura University, Saudi Arabia.

METHODS

This was a cross-sectional study using a self-administered online questionnaire completed by final-year medical students and interns during January and February 2022. We collected data on demographics, academic year, critical care knowledge, competency, and satisfaction.

RESULTS

Two-hundred-twenty-one (221) responses were analyzed. The male gender was 54.3%. A small proportion (15.8%) identified the lowest acceptable oxygen saturation in a normal person. Around three-quarters of the participants did not feel competent about nasal airway suctioning and endotracheal tube suctioning (65.6% and 75.6%, respectively). Only 7.2% of the responder correctly identified the three most useful physiological observations pertinent to quick SOFA criteria. Regarding the training adequacy for identifying critically ill patients, 59.3% answered that they are inadequately trained. Regarding the satisfaction level of exposure to critical care, 54% of the sample responded that they need further improvement.

CONCLUSION

Undergraduate students and interns have limited knowledge and confidence in critical care medicine. Thus, we highly recommend an early institution of a dedicated critical care training module in the medical school curriculum.

An evaluation of the effectiveness of induction programmes on foundation doctor preparedness: a rapid review of the literature

There is an increase in mortality when medical graduates replace the previous cohort of foundation doctors. As of 2012, it is now mandatory for new doctors in the UK to participate in induction training in order to ease this transition and reduce the negative impact on patient outcomes. However, there is no guidance on how best to deliver these induction programmes. This review aims to evaluate the effectiveness of several induction programmes to provide insight on this. Medline and Scopus were searched for relevant literature using keywords. Duplicates were removed and inclusion criteria were created to screen the remaining literature. Five studies were included in this review and they were all quality appraised using the Medical Education Research Study Quality Instrument. Different hospital trusts utilised varying induction programmes. The most common method of assessing their effectiveness involved exploring preparedness in junior doctors post-induction through surveys. Patient outcome, anxiety levels and knowledge were also measured. Induction programmes play a vital role in preparing new foundation doctors for practice and thus improving patient outcomes. Although there may be trust-specific variation, some elements of the programme should be standardised to ensure basic requirements are met universally. New doctors should be assessed on aspects of the programme after completion to increase confidence and knowledge. Organisational considerations such as costs and staff availability need to be taken into account. The quality of future research papers could be improved through inclusion of baseline data, control groups, multi-centred studies and outcomes higher on Kirkpatrick’s hierarchy.

Knowledge and Confidence of Final-Year Medical Students Regarding Critical Care Core-Concepts, a Comparison between Problem-Based Learning and a Traditional Curriculum

BACKGROUND

Medical undergraduates should be prepared to recognize life threating critical conditions. Undergraduate medical curriculum development to incorporate more critical care education is an essential requirement. Problem Based Learning curriculum has a potential advantage in providing more focused critical care education to medical undergraduate.

OBJECTIVES

We aimed to evaluate the final year medical students' knowledge and confidence in key critical care concepts in Problem Based Learning (PBL) curriculum compared to those in Traditional (Lecture) Based Learning curriculum. We also aimed to evaluate undergraduate's level of satisfaction with the exposure to critical care education during medical education and training.

MATERIALS AND METHODS

This is a cross-sectional anonymous self-administered survey questionnaire completed by two groups of final-year medical students (PBL and TBL) from three Saudi medical schools to assess the degree of undergraduate exposure to critical care and their knowledge of key critical care assessment parameters.

RESULTS

The responses of 279 final year medical students was analyzed (70% response rate). The majority (53%) was male and the mean age 23.9 ± 1.4 years. Only 13% of students felt confident to manage hypovolemic shock and 15% could recognize the signs of a threatened airway. One third of the students (29%) correctly identified the critical level of lactic acid in shock and less than 2% of the sample responded correctly to all the questions related to the formal assessment of critically ill patients. Lectures were the main source of information in acute care. More than two-thirds (46%) of the sample indicated that they received tuition in critical care, however the total duration spent in a critical care rotation or teaching was 1 day or less. The medical students, who completed their training with a Problem-Based Learning curriculum, had a higher knowledge base and were more confident in many critical care concepts. Only 6.5% choose critical care as their likely future career.

CONCLUSION

Medical undergraduates in PBL have an overall better knowledge on key concepts and assessment tools applicable to evaluating and managing critically ill patients compared to students in TBL. However the gap in knowledge and confidence in assessing ill patients in both groups is evident. Critical care was not chosen as a preferred future career in all surveyed students. There is a need for institutional support and endorsement of undergraduate critical care exposure and education in Saudi Universities both to better prepare medical students for their imminent post-graduates exposure to ill patients and to help in closing the gap in critical care physicians through promoting the specialty.