Implementation and Evaluation of a Trainee Orientation Manual in an Intensive Care Unit Rotation

Maria C Cañizares-Otero; Aunie M Danyalian; Daniel P High; Pamela Vieira; Christian Almanzar Zorilla; Jasmine Dew; Chi Chan Lee; Idle M Lee; Raiko Diaz; Daniel Zapata; Mauricio Danckers

doi:10.34197/ats-scholar.2023-0007OC

Implementation and Evaluation of a Trainee Orientation Manual in an Intensive Care Unit Rotation

ATS Sch. 2023 Dec 20;5(1):109-121. doi: 10.34197/ats-scholar.2023-0007OC. eCollection 2024 Mar.

Authors

Maria C Cañizares-Otero¹, Aunie M Danyalian^{1

2}, Daniel P High^{1

2}, Pamela Vieira¹, Christian Almanzar Zorilla^{1

2}, Jasmine Dew¹, Chi Chan Lee³, Idle M Lee⁴, Raiko Diaz^{1

2}, Daniel Zapata⁴, Mauricio Danckers^{1

2}

Affiliations

¹ Department of Medicine and.
² Division of Critical Care Medicine, HCA Florida Aventura Hospital, Aventura, Florida.
³ Department of Critical Care, Guam Regional Medical City, Tamuning, Guam; and.
⁴ Division of Critical Care Medicine, HCA Florida Kendall Hospital, Miami, Florida.

Abstract

Background: The intensive care unit (ICU) rotation places trainees in a fast-paced, high-intensity environment that requires complex patient care and multidisciplinary coordination. Trainees seek continuous medical knowledge acquisition while tasked with learning ICU-specific workflows, procedures, and policies. The unfamiliarity with rotation logistics and administrative roles and expectations could hinder the ICU rotation learning experience. A lack of standardization and material for trainee orientation to administrative ICU tasks and workflows could affect the trainee's rotation performance and overall learner satisfaction.

Objective: We evaluated the implementation of an ICU trainee manual to provide trainees with a source of orientation for rotation logistics and nonclinical ICU tasks. We assessd its impact on content retention, learners' satisfaction with the manual, and overall ICU rotation experience.

Methods: We designed an observational, prospective cohort study that included all trainees scheduled to rotate in the ICU during the 2020-2021 academic year. The ICU manual was delivered electronically and was available throughout the academic year. Trainees received a survey before their first ICU rotation (pretest) and 6 months after their first ICU rotation (retest) to assess content retention, trainees' perception of the ICU manual, and overall rotation satisfaction.

Results: A total of 95 trainees completed the pretest survey, and 61 completed the retest survey. The target cohort response rate for each survey was 100%. Pretest scores were higher than the matched retest scores (41 of 48 [interquartile range, 37-44] vs. 38 of 48 [34-41]; P < 0.001). The median ICU manual satisfaction score was 32 of 40 (26-36.5). We found positive correlations between ICU manual trainee satisfaction score and the retest score (r[59] = 0.320; P = 0.01) and ICU rotation trainee satisfaction level (r[59] = 0.909; P < 0.001).

Conclusion: Implementing an ICU manual to orient trainees to their ICU clinical rotation was well received and showed continued retention of orientation content. Higher ICU rotation trainee satisfaction levels were related to a positive perception of the ICU manual.

Keywords: ICU orientation; critical care medicine; graduate medical education.