C. Meschia1, D. Weigle1, C. Izzo1, J. Zhang1, M. Crandall1, D. Ebler1, T. S. Hester1, J. Humanez1, S. Jain1, M. Kochuba1, T. Husty1, K. Lydon1, F. Madbak1, L. Neumayer1, R. Warner1, C. White1, B. Yorkgitis1, D. Skarupa1 1University of Florida Jacksonville, Surgery, Jacksonville, FL, USA
Introduction:
Critical care is a core component of both inpatient care and resident education in multiple specialties. At this institution, resident supervision was previously provided by an in-house acute care surgeon who also maintained other clinical responsibilities. In effort to provide enhanced attending-level resources and supervision to overnight ICU residents, the critical care resource intensivist (CCRI) program was incorporated, wherein a dedicated ICU attending is present overnight. A previous study was performed to determine the perceptions of general surgery residents on the impact of the CCRI on education and patient care. The goal of this study is to expand this inquiry to multiple resident specialties in the critical care setting, as well as to compare resident experiences preceding versus after implementation of the CCRI model.
Methods:
The Qualtrics survey platform was utilized to send anonymous surveys to residents within the specialties of anesthesiology (AN), emergency medicine (EM), internal medicine (IM), and general surgery (GS). Demographic information elicited included post-graduate training year (PGY), specialty, and chronological relationship to implementation of CCRI. 4-point Likert Scale and free text questions were included.
Results:
Of 138 total residents (16 AN, 46 EM, 51 IM, 25 GS), 82 completed the survey (59.4%). Respondent stratification included 31 PGY-1 (38%), 22 PGY-2 (27%), 17 PGY-3 (21%), 6 PGY-4 (7%), 6 PGY-5 (7%); 11 AN (14%), 18 EM (22%), 29 IM (35%), 24 GS (29%); 7 (9%) only before CCRI, 26 (32%) before and after, and 48 (59%) only after implementation. Composites of strongly agree/agree on positive perception of attending availability (95%), improved patient care (98%), education (87%), and procedural skill (78%) and disagree/strongly disagree on perception of CCRI limiting autonomy (79%) or detracting from education (83%) were noted.
Conclusion:
The CCRI model was implemented to enhance both educational and clinical support of residents in the ICU overnight; however, consideration is given to the perceived impact on resident education and autonomy. Across multiple disciplines and post-graduate training years, residents have indicated a favorable perceived impact of the CCRI on education, clinical support, and procedural skill with no significant impairment to autonomy.