Acute Care Training Research Articles

A fighting chance: how acute care training is failing patients with chronic disease.

Watching the decline of two patients with kidney failure—one healthier and one frail—a doctor questions how well acute care medical training serves those with chronic disease.

A blended design in acute care training: similar learning results, less training costs compared with a traditional format.

Introduction There is a demand for more attractive and efficient training programmes in postgraduate health care training. This retrospective study aims to show the effectiveness of a blended versus traditional face-to-face training design. For nurses in postgraduate Acute and Intensive Care training, the effectiveness of a blended course design was compared with a traditional design. Methods In a first pilot study 57 students took a traditional course (2-h lecture and 2-h workshop) and 46 students took a blended course (2-h lecture and 2-h online self-study material). Test results were compared for both groups. After positive results in the pilot study, the design was replicated for the complete programme in Acute and Intensive Care. Now 16 students followed the traditional programme (11 days face-to-face education) and 31 students did the blended programme (7 days face-to-face and 40 h online self-study). An evaluation was done after the pilot and course costs were calculated. Results Results show that the traditional and blended groups were similar regarding the main characteristics and did not differ in learning results for both the pilot and the complete programme. Student evaluations of both designs were positive; however, the blended group were more confident that they had achieved the learning objectives. Training costs were reduced substantially. Conclusion The blended training design offers an effective and attractive training solution, leading to a significant reduction in costs.

Undergraduate training in the care of the acutely ill patient: a literature review

To characterise the problem of teaching acute care skills to undergraduates and to look for potential solutions. Systematic literature review including Medline, EMBASE, CINAHL. Eligible studies described education and training issues focusing on caring for acutely ill patients. Articles were excluded if they did not address either educational or clinical aspects of acute care and resuscitation. We identified and reviewed 374 articles focusing on training or clinical aspects of caring for the acutely ill patient. Undergraduates and junior physicians lack knowledge, confidence and competence in all aspects of acute care, including the basic task of recognition and management of the acutely ill patient. There is wide variability both between and within countries regarding the amount of teaching in critical care offered to undergraduate medical students. Many centres are starting to use an integrated approach to acute care teaching, with early exposure to basic life support and clinical skills, coupled with later exposure to more complex acute care topics. Clinical attachments remain a popular method for training in acute care. Acute care courses are increasingly being used to standardise delivery of practical skills and patient management training. The training of healthcare staff in the care of acutely ill patients is suboptimal, adding to patient risk. Improvements in training should start at undergraduate level for maximal effect, should be integrated with postgraduate education, and are likely to enhance current efforts to improve patient safety in acute care.

Simulation Based Teaching Improves Acute Care Knowledge and Skills in both A Graduate and Undergraduate Medical Student Population.

BACKGROUND: Evidence from a number of UK teaching hospitals suggests that students are graduating from medical school without the necessary practical knowledge and skills to function independently and safely, particularly in the acute setting. During clinical attachments at the University of Nottingham undergraduate medical students who have previously experienced mainly didactic teaching are joined by graduate entry medical (GEM) students who have studied a problem based learning course. This abstract describes our experience of introducing an additional simulation-based acute care training programme earlier in the undergraduate curriculum as part of the student’s first clinical attachment. Furthermore we are able to compare GEM and undergraduate student exam performance. METHOD: The course consists of five half-day sessions over a 10-week period. The first session introduces the basic topics to be covered throughout the course and the students receive detailed written material. Sessions 2–4 use a simulation-based approach encouraging students to work through nine short clinical scenarios. A process of self-evaluation allows the students to feedback their individual strengths and weaknesses. This data is reviewed and used to design the final session. Assessment for the course includes a pre and post course written exam and an end of course objective structured clinical exam (OSCE). Statistical analysis was performed using an unpaired student’s t-test. RESULTS:Table 1: Examination scoresCONCLUSIONS: This new programme improved medical students knowledge and skills in providing immediate assessment and management of acutely ill patients at an early stage in their clinical training. However the simulation based OSCE detected unacceptable performance of key skills in some students who had passed their modified EMQ assessment. Despite a problem-based education GEM students did not significantly out perform the undergraduate students in the end of course assessments.

The ACUTE initiative

Universities need to establish formal acute care training programmes in their curriculums, as Gavin Perkins and Julian Bion discuss

PACT: An ESICM Multidisciplinary Distance Learning Programme for Intensive Care Training

Intensive Care Medicine (ICM) is a medical specialty where doctors from a variety of disciplinary backgrounds manage the medical care of critically ill patients. Training and continuing education for these doctors involves the acquisition and maintenance of the knowledge, skills and attitudes which allow them to manage the most severely ill. In order to improve and harmonise the quality of intensive care medicine, the European Society of Intensive Care Medicine (ESICM) is producing a distance learning programme: Patient-Centred Acute Care Training (PACT) for the training of doctors working in intensive care and acute medicine.