Introduction/Hypothesis: Training physicians to care for undifferentiated critically ill patients present a multitude of challenges, most especially balancing trainee supervision with autonomy while ensuring patient safety. In response to these… Click to show full abstract
Introduction/Hypothesis: Training physicians to care for undifferentiated critically ill patients present a multitude of challenges, most especially balancing trainee supervision with autonomy while ensuring patient safety. In response to these challenges, we developed a novel elective freeing trainees from other clinical responsibilities to follow critically ill patients throughout their clinical course from initial presentation through ICU course. This was a pilot study assessing the satisfaction and self-efficacy of EM residents who completed a resuscitation-centered EDbased elective that includes clinical and didactic components. Methods: We completed a survey of EM residents participating in a novel resuscitation elective from July 2018 through June 2019. Trainees self-selected for participation in a four-week experience overseen by EM-Critical Care trained faculty. Over the four weeks there were approximately 25 contact hours of didactics and each trainee completed approximately 15 resuscitation shifts. Residents were based in the ED to participate in the initial resuscitation of undifferentiated critically ill patients. Upon disposition of these patients, the “resuscitation resident” was to remain at the bedside to continue resuscitation, observing the dynamic pathophysiology, and accompany the patient to their final ICU destination. After completion of the elective students were surveyed to gauge their satisfaction with the elective and the perceived effects on their learning and practice. Results: The response rate to the survey was 85% (6/7) including PGY-1 through PGY-4 residents. 100% of participants agreed the Resuscitation Elective significantly contributed to enhancing their skills as a resuscitationist. Trainees saw significant improvement in their self-perceived efficacy in identifying and managing all shock states and cardiac arrest as a result of their experience in the elective Conclusions: The Resuscitation Elective, a novel ED-based critical care elective, shows promise as an effective teaching tool that could supplant the need for traditional ICU experiences. Future directions include comparing the effect of this method of education against more traditional ICUelectives among various learner levels and specialty.
               
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