1029: IMPROVING THE INTENSIVE CARE UNIT ROTATION EXPERIENCE: THE USE OF A MANUAL FOR TRAINEE ORIENTATION

Abstract

Introduction: Clinical rotations for residents in the intensive care unit (ICU) could be challenging due to the complexity of cases, acuity of care, and lack of prior experience. An effective and timely rotation orientation may facilitate the need for rapid adjustment of trainees to their rotation roles and acknowledgement of expectations while increasing trainee rotation satisfaction (Gaetke-Udager 2015, Singer 2013). The aim of this study is to assess the utilization of an ICU orientation manual to facilitate the learning experience. Methods: Trainees scheduled for an ICU rotation during the academic year were provided with the manual prior to their first rotation. A prospective study was conducted in a community based medical ICU. All medical trainees assessed on their knowledge in workflow, clinical care, documentation, equipment and procedures prior to and after their ICU rotations. The level of satisfaction with the manual as an orientation tool and overall experience satisfaction were also assessed. Results: A total of 95 and 61 trainees completed the pre and post-rotation test respectively. There was a significant decrease in the median score, among paired samples, between the pre and post-test (41 [37-44] vs. 38 [34-41], p <.001). Pre-test scores were higher than post-test scores for emergency medicine (39.5 [36-43.5 vs. 33 [30-36.75], p< .01) and pulmonary and critical care (44 [39-46] vs. (39 [36-40], p<.03) trainees but not for internal medicine trainees. ICU manual training satisfaction score significantly correlated with the post-test score (r[59]=.320, p=.01) and strongly correlated with ICU rotation trainee satisfaction level (r[59] = .909, p<.001). Conclusions: Our study revealed lower ICU manual content retention scores in emergency medicine residents and pulmonary and critical care fellows, yet consistent scores among internal medicine residents. Trainees with higher ICU manual satisfaction levels as an orientation tool exhibited higher content retention and overall rotation satisfaction. Educators should consider a tailored orientation process among trainees based on their training program and consider reinforcing orientation after each academic year. Trainee satisfaction with ICU orientation material could be indicative of their overall ICU rotation satisfaction.