A Longitudinal Regional Educational Model for Pulmonary and Critical Care Fellows Emphasizing Small Group- and Simulation-based Learning

Shah, Nirav G.; Seam, Nitin; Woods, Christian; Fessler, H; Goyal, Munish; McAreavey, Dorothea; Lee, Burton W.

doi:10.1513/annalsats.201601-027ar

Cited by 10 publications

(3 citation statements)

References 14 publications

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“…For the 73 study subjects, MV education was provided as part of a multiinstitutional collaboration in which fellows from several critical care fellowships were taught various key critical care topics ( 14 ). The MV course consisted of two parts.…”

Section: Methodsmentioning

confidence: 99%

Impact of Novel Multiinstitutional Curriculum on Critical Care Fellow Ventilator Knowledge

et al. 2021

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Background: Management of mechanical ventilation (MV) is a curricular milestone for trainees in pulmonary critical care medicine (PCCM) and critical care medicine (CCM) fellowships. Though recognition of ventilator waveform abnormalities that could result in patient complications is an important part of management, it is unclear how well fellows recognize these abnormalities. Objective: To study proficiency of ventilator waveform analysis among first-year fellows enrolled in a MV course compared with that of traditionally trained fellows. Methods: The study took place from July 2016 to January 2019, with 93 fellows from 10 fellowship programs completing the waveform examination. Seventy-three fellows participated in a course during their first year of fellowship, with part I occurring at the beginning of fellowship in July and part II occurring after 6 months of clinical work. These fellows were given a five-question ventilator waveform examination at multiple time points throughout the two-part course. Twenty fellows from three other fellowship programs who were in their first, second, or third year of fellowship and who did not participate in this course served as the control group. These fellows took the waveform examination a single time, at a median of 23 months into their training. Results: Before the course, scores were low but improved after 3 days of education at the beginning of the fellowship (18.0 ± 1.6 vs. 45.6 ± 3.0; P < 0.0001). Scores decreased after 6 months of clinical rotations but increased to their highest levels after part II of the course (33.7 ± 3.1 for part II pretest vs. 77.4 ± 2.4 for part II posttest; P < 0.0001). After completing part I at the beginning of fellowship, fellows participating in the course outperformed control fellows, who received a median of 23 months of traditional fellowship training at the time of testing (45.6 ± 3.0 vs. 25.3 ± 2.7; P < 0.0001). There was no difference in scores between PCCM and CCM fellows. In anonymous surveys, the fellows also rated the mechanical ventilator lectures highly. Conclusion: PCCM and CCM fellows do not recognize common waveform abnormalities at the beginning of fellowship but can be trained to do so. Traditional fellowship training may be insufficient to master ventilator waveform analysis, and a more intentional, structured course for MV may help fellowship programs meet the curricular milestones for MV.

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Section: Methodsmentioning

confidence: 99%

Impact of Novel Multiinstitutional Curriculum on Critical Care Fellow Ventilator Knowledge

et al. 2021

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“…If a free-text option for response is given, a specific plan for analyzing those free-text responses (e.g., content analysis) should be specified. Last, many surveys, particularly those in medical education, may involve longitudinal assessment and/or pre–post designs (e.g., curricular assessment) ( 42 , 43 ). In these cases, statistical techniques accounting for repeated measures within the same subjects or summary measures that measure differences over time should be used carefully and in consultation with experts in statistics.…”

Section: Analyzing Survey Resultsmentioning

confidence: 99%

Keys to Successful Survey Research in Health Professions Education

Hochberg,

Eakin

2024

ATS Scholar

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Background Survey research is well suited to measuring the knowledge, behavior, and attitudes of study participants and has been widely used in medical education and pulmonary and critical care medicine research. Although the ease of survey administration via electronic platforms has led to an increased volume of survey publications, improving the quality of this work remains an important challenge. Objective To provide an overview of key steps for rigorous survey design and conduct. Methods Narrative review. Results Conducting survey research begins with a clearly defined research question pertaining to a specified population that is accessible for sampling. Survey investigators may choose to adapt relevant preexisting survey instruments, an approach with the potential for conducting more valid, generalizable, and comparable studies. If a new survey tool is used, more extensive piloting and psychometric analysis of the survey instruments may be needed to assess if they accurately measure the concepts of interest. When administering the survey, the use of appropriate methods for sample recruitment maximizes the chances of a high response rate in a generalizable study population. Finally, when writing up and disseminating survey research, careful attention to reporting guidelines can increase the clarity of survey reports and assist readers in interpreting the results and conclusions. Conclusion With careful attention to study design and conduct, the quality of survey research can be improved and lead to higher impact and more generalizable studies in the fields of medical education and pulmonary and critical care medicine.

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“…Despite the implementation of academic boot camps by PCCM fellowships, orientation and introductory training practices vary widely by program ( 31 ). Although some programs are able to offer immersive introductory boot camps to their fellows, comprehensive programs are often limited to larger fellowships or to collaborations between multiple fellowship programs within a close geographic area ( 32 ). Many programs, because of program size; clinical, educator, or cost constraints; or geographic isolation, are unable to provide a comprehensive boot camp program.…”

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confidence: 99%

Development of a National Academic Boot Camp to Improve Fellowship Readiness

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Background: Pulmonary and critical care medicine (PCCM) fellowship requires a high degree of medical knowledge and procedural competency. Gaps in fellowship readiness can result in significant trainee anxiety related to starting fellowship training. Objective: To improve fellowship readiness and alleviate anxiety for PCCM-bound trainees by improving confidence in procedural skills and cognitive domains. Methods: Medical educators within the American Thoracic Society developed a national resident boot camp (RBC) to provide an immersive, experiential training program for physicians entering PCCM fellowships. The RBC curriculum is a 2-day course designed to build procedural skills, medical knowledge, and clinical confidence through high-fidelity simulation and active learning methodology. Separate programs for adult and pediatric providers run concurrently to provide unique training objectives targeted to their learners’ needs. Trainee assessments include multiple-choice pre- and post-RBC knowledge tests and confidence assessments, which are scored on a four-point Likert scale, for specific PCCM-related procedural and cognitive skills. Learners also evaluate course material and educator effectiveness, which guide modifications of future RBC programs and provide feedback for individual educators, respectively. Results: The American Thoracic Society RBC was implemented in 2014 and has grown annually to include 132 trainees and more than 100 faculty members. Mean knowledge test scores for participants in the 2019 RBC adult program increased from 55% (±14% SD) on the pretest to 72% (±11% SD; P < 0.001) after RBC completion. Similarly, mean pretest scores for pediatric course attendees increased from 54% (±13% SD) to 62% (±19% SD; P = 0.17). Specific content domains that improved by 10% or more between pre- and posttests included airway management, bronchoscopy, pulmonary function testing, and code management for adult course participants, and airway management, pulmonary function testing, and extracorporeal membrane oxygenation for pediatric course participants. Trainee confidence also significantly improved across all procedural and cognitive domains for adult trainees and in 10 of 11 domains for pediatric course attendees. Course content for the 2019 RBC was overwhelmingly rated as “on target” for the level of learner, with <4% of respondents indicating any specific session was “much too basic” or “much too advanced.” Conclusion: RBC participation improved PCCM-bound trainee knowledge, procedural familiarity, and confidence. Refinement of the RBC curriculum over the past 7 years has been guided by educator and course evaluations, with the ongoing goal of meeting the evolving educational needs of rising PCCM trainees.

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A Longitudinal Regional Educational Model for Pulmonary and Critical Care Fellows Emphasizing Small Group- and Simulation-based Learning

Cited by 10 publications

References 14 publications

Impact of Novel Multiinstitutional Curriculum on Critical Care Fellow Ventilator Knowledge

Impact of Novel Multiinstitutional Curriculum on Critical Care Fellow Ventilator Knowledge

Keys to Successful Survey Research in Health Professions Education

Development of a National Academic Boot Camp to Improve Fellowship Readiness

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