NEEDS ASSESSMENT FOR TRAINING IN CRITICAL CARE

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NEEDS ASSESSMENT FOR TRAINING IN CRITICAL CARE

• JAN MAR 2003
• ICS EDUCATION TRAINING COMMITTEE

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WHY DID WE DO IT?

• CCST IN CRITICAL CARE NOW OBTAINABLE
• EWTD FULL SHIFT ROTAS
• STEP 1 STEP 2 TRAINING
• LACK OF INFORMATION AT GRASS ROOTS LEVEL

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• THIS IS OUR CHANCE TO DEVELOP A NEEDS BASED,
  MODERN, FLEXIBLE EDUCATION AND TRAINING PACKAGE

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METHOD

• NO FUNDING
• INITIAL E MAIL QUESTIONNAIRE SURVEY TO TRAINEES
  WHO HAD VOLUNTEERED ADDRESSES (N90) (E MAIL
  SURVEY)
• QUESTIONNAIRE HANDED OUT AT THE STATE OF THE
  ART MEETING IN 2002 (MEETING SURVEY)
• NOT COMPREHENSIVE BUT MORE THAN WE HAVE AT PRESENT

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• RESULTS

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MEETING SURVEY HIGHLIGHTS

• N31 RESPONDENTS
• THE VAST MAJORITY WERE CONSULTANTS WITH A BASE
  SPECIALITY IN ANAESTHESIA
• SHORT BUT FREQUENT MEETINGS WERE PREFERRED TO
  LONGER BUT LESS FREQUENT
• 83 WANTED TO BE ABLE TO GET TOGETHER AND TALK
  NOT NECESSARILY WITH AN ORGANISED FORMAT
• ALS FORMAT WAS THOUGHT GOOD FOR BASIC LEVEL
  TRAINING BUT NOT FOR ADVANCED TRAINING OR
  PRESUMABLY CONSULTANT UPDATE?
• 80 HAVE NOT USED PACT AND DO NOT KNOW MUCH
  ABOUT IT
• 67 WOULD ATTEND A DEDICATED ICU MANAGEMENT
  COURSE
• 67 WOULD ATTEND A DEDICATED ICU TEACHING COURSE

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WHO ANSWERED THE MEETING QUESTIONNAIRE?
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IF AN EDUCATION PROGRAM WAS INTRODUCED AT WHAT
LEVEL SHOULD IT BE LEAD ?
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WHO DO YOU THINK SHOULD DELIVER THE PROGRAM?
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WHAT METHOD OF DELIVERY SHOULD WE USE?
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WHAT PROBLEMS ARE THERE HINDERING YOUR
EDUCATIONAL ABILITY OR YOUR ABILITY TO EDUCATE
OTHERS ?
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E MAIL SURVEY HIGHLIGHTS

• N28
• PRACTICALLY NO ONE HAS HEARD OF PACT
• SHORT BUT FREQUENT MEETINGS ARE PREFERRED TO
  INFREQUENT LONGER MEETINGS
• OVER 90 HAVE DONE ALS AND ATLS
• THEY LIKE THIS FORMAT FOR BASIC LEVEL TRAINING
• 90 INDICATED THAT THEY WOULD LIKE TO BE ABLE TO
  GET TOGETHER AND TALK AS WELL AS HAVE STRUCTURED
  FORMAL TEACHING

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IF AN EDUCATIONAL PROGRAM WAS INTRODUCED WHO DO
YOU THINK SHOULD DELIVER IT? (E MAIL SURVEY)
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IF AN EDUCATIONAL PROGRAM WAS INTRODUCED AT WHAT
LEVEL DO YOU THINK IT WOULD BEST BE DELIVERED AT?
(E MAIL SURVEY)
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WHAT IMMEDIATE CHANGES TO THE WAY YOU ARE TRAINED
WOULD YOU LIKE TO SEE? (E MAIL SURVEY)

• More meetings at trainee level
• More formal training time as SHO/SpR1/2 and less
  service time as in anaesthesia
• A more structured training program
• Service work appropriate and training time
  protected
• Service vs. Training need to be addressed
• Clearer direction and info about what is
  available and what you need
• Identification of specialist units for specific
  areas
• A system like the one in Australia possibly with
  a meaningful exam at the end
• More theoretical training in ICM rather than the
  emphasis on anaesthesia as at present
• One full day for training every few months as
  opposed to one afternoon a week.
• Non-clinical teaching e.g.. Blood gas machines,
  management and getting a consultant job.
• Recognize a full year of overseas time for
  advanced training
• A more structured system/disease based teaching
  program
• Training vs. Service time on the unit
• On the job teaching
• Clear distinction between junior and senior
  advanced trainees on the unit in terms of
  responsibility etc.
• Advanced trainees should be able to run the unit
  with distant supervision
• More formal structured teaching
• Clearer defined syllabus, the diploma feels like
  it is likely to shift

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OTHER COMMENTS WORTH NOTING FORM BOTH SURVEYS

• Basic level training best suites the ALS etc
  style. Advanced training does not. Outside of the
  box type style should be used. This thought is
  echoed again and again by both juniors and
  consultants.
• There is little centralized training compared to
  other countries
• Combination of teaching methods may be better
  than one for advanced trainees
• As long as intensive care remains a sub-specialty
  of anaesthesia the training needs and objectives
  of ICU trainees will not be met
• Shift patterns will drastically change the way we
  deliver teaching and ICS guidance would be great
• The most limiting factor for teaching is lack of
  staff, small groups and people being called away
  for clinical requirements

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SUMMARY

• FREQUENT SHORT MEETINGS ARE POPULAR
• LITTLE SUPPORT AT PRESENT FOR A PURELY COMPUTER
  BASED LEARNING METHOD
• INFORMAL TIME TO TALK SHOULD BE BUILT INTO DAY
  MEETINGS
• THE IMPACT OF FULL SHIFTS ON TRAINING DELIVERY
  DOES NOT SEEM TO HAVE OCCURRED YET
• MOST CRITICAL CARE TRAINEES HAVE ATTENDED ALS
  STYLE COURSES AND IT SEEMS FUTILE TO REINVENT
  THESE
• PACT IS ESSENTIALLY UNKNOWN
• WIDE SUPPORT FOR TEACHING AND MANAGEMENT COURSES
• SERVICE VS. TEACHING REQUIREMENTS IS A VERY LARGE
  PROBLEM FOR TRAINEES AND CONSULTANTS
• TRAINING SHOULD BE MANAGED AT A REGIONAL LEVEL
  AND NOT A LOCAL OR NATIONAL LEVEL