Benefit of Structered Presentation Templates for the Learning Resident in the Intensive Care Unit
Year: 2021
Type: conference-abstract
Abstract: Rationale:Presentations in the intensive care unit (ICU) serve as medical checklist to ensure high standards of care. High quality presentations promote better coordinated care, efficiency, and learning. Residents are taught to follow the simple SOAP format that can be difficult in the ICU as patients are often unable to interact or answer questions. We hypothesize that providing our trainees with a template formatted specifically to the ICU improves content, presentation skills, and capacity for patients' evaluation.Methods:internal medicine, family medicine, and emergency medicine interns were included. Categories in the ICU-tailored template were identified: subjective/interval events, vital signs, in's and out's, physical exam, laboratory results, imaging, assessment and plan, venous thromboembolism (VTE) prophylaxis, stress ulcer prophylaxis, nutrition, bowel regimen, physical therapy (PT)/occupational therapy (OT), tubes/lines/drains, and case management issues. A checklist was developed from this list and was used to grade resident presentations. Credit was only given if a category was supplied by the intern without prompting from the attending physician. A categoty mentioned in at least 50% in presntations was considered as positive improvement to receive credit. A questionnaire grading the interns' perception to present effectively and their comfort level during rounds was also provided. For each statement, they graded on a scale of 1-5; 5 being strongly agree and 1 strongly disagree. Trainees were given the same questionnaire after receiving the teaching resources, and final observation was performed.Results: 41 resident presentations were observed prior and after introduction of the template. Prior to template introduction the only categories mentioned in >50% of all presentations were the subjective (100%), vitals (74.29%), laboratory values (62.86%), and assessment and plan (60%). After template introduction resident presentations improved as categories captured in >50% of presentations included subjective (100%), vitals (100%), I&Os (90.24%), Physical exam (80.49%), Labs (100%), Imaging (78.05%), Assessment and plan (95.12%), VTE prophylaxis (80.49%), Stress ulcer prophylaxis (78.05%), and nutrition (58.54). VTE prophylaxis, Stress ulcer prophylaxis, Nutrition, Bowel regimen, PT/OT, and tube/lines/drains were either not mentioned at all or only mentioned in 1-2 presentations prior to template intervention increased significantly in frequency mentioned but may not have quite met the >50% threshold. When comparing the average pre-template and post-template scores, there was a significant increase in confidence. In addition, the average time to prepare declined from 23.125min pretemplate to 19.625min post-template, a 15.18% decrease.Concusions: Our findings suggest that standardization of ICU presentation templates improves patients' care, residents confidence, and decreases preparation time.
Authors: R.I. Bechara, J.N. Gonzales, A. Westbrook
Institution: Augusta University
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4232830250