ATTENDING PHYSICIANS' PERCEPTIONS AND ATTITUDES OF TEACHING HOUSESTAFF IN THE MEDICAL ICU

Abstract

TOPIC: Education, Research, and Quality Improvement TYPE: Original Investigations PURPOSE: The education of residents in critical care is largely accomplished through teaching while they rotate through the medical intensive care unit (MICU). A didactic curriculum to enhance critical care education of house staff in our MICU exists, but it's effectiveness is hindered by limited implementation and inconsistent use. In this study, we hope to identify barriers to implementation and ideas to inform the routine and self-sustaining use of the curriculum. METHODS: The study was a prospective survey of the attitudes of MICU attending faculty at a single-center. All faculty who attend in the MICU at least 4 weeks annually were invited to participate. The study was IRB-approved and consent was obtained. The survey was completed through an anonymous, web-based survey. RESULTS: 21 people met inclusion criteria. There were 12 responses to the survey, giving a response rate of 57%. One declined to consent to participate. Out of the 11 who consented to participate, 9 (81%) know there is a formal MICU curriculum. Out of those 9, 6 (67%) reported using it to teach. The top three motivations for teaching are to improve housestaff knowledge, because they enjoy it (each chosen by 10 respondents, 91%), and because they think teaching can improve patient care (chosen by 9 respondents, 82%). 7 (64%) identified improving housestaff knowledge as the most important factor. Many barriers to teaching in the MICU were identified, with the team being too busy (9/11, 82%), not having sufficient time to prepare content (6/11, 55%), and not knowing what housestaff have already been taught (4/11, 36%) being the top three barriers. 5 (45%) identified the team being too busy as the most important barrier. Respondents identified ways to overcome these barriers by establishing protected teaching time in the MICU (7/11, 64%) and if all MICU attendings consistently taught when on service (5/11, 45%). Having off-service faculty come to the MICU to teach and improving the physical space for teaching were each identified by 4 respondents (36%). CONCLUSIONS: The responses confirm that the majority of faculty enjoy teaching and believe it improves housestaff knowledge and patient care. The majority are aware of the curriculum, however the primary barriers to teaching are lack of time and a busy team, which hinders the use of the curriculum, but also teaching of any kind. The majority of respondents proposed dedicating a protected time for teaching and commitment from all faculty to teach in that time, as the most important means to overcome the barriers. CLINICAL IMPLICATIONS: Our initial purpose was to identify barriers to implementation of an existing formal curriculum. Given our survey results identified the most important barriers as lack of protected time for education and the time pressures the team experiences, we hypothesize that scheduling a set daily time for teaching is a necessary first step in order to increase teaching in the MICU. We will address that intervention first; if we are successful, then we plan to subsequently study best practices for implementing the prepared curriculum, including trials of novel interventions for our MICU, such as off-service faculty coming to the MICU to teach. DISCLOSURES: No relevant relationships by Anna Brady, source=Web Response No relevant relationships by Marin McCutcheon, source=Web Response