Teaching medical students complex cognitive skills in the intensive care unit.
OBJECTIVE
To determine if fourth-year medical students can learn the high-level cognitive skills needed to manage critically ill patients during a critical care medicine elective designed in accordance with established educational principles.


METHODS
Students were randomly assigned to take one of two examinations with ten short essay questions to complete on the initial day. After the elective, students completed the other examination in a crossover design.


METHODS
Five surgical intensive care units (ICUs) in a tertiary care university teaching hospital.


METHODS
Fourth-year medical students enrolled in the critical care medicine elective.


METHODS
All students were enrolled in a critical care medicine elective consisting of an orientation, interactive conferences, technical skills laboratories, daily rounds, and patient-care experience. These components were designed to encourage problem-solving, improve analytical skills, and minimize the deterrents to education in the ICU.


METHODS
The primary outcome measure was the difference in examination scores before and after the rotation. Examinations were designed to test the student's skills in application, analysis, synthesis and evaluation. Specific questions concerning hemodynamic assessment were compared.


RESULTS
The students' mean pre-elective scores were 58.8 +/- 10.8%, compared with 85.5 +/- 9.4% after the elective (p < .0001).


CONCLUSIONS
Students can learn cognitive components of patient management skills using a format that encourages judgment, decision-making, and analytical skills, despite the liabilities inherent to education in an ICU.
Rogers
P L
PL
Department of Anesthesiology and Critical Care Medicine, University of Pittsburgh, PA.
Grenvik
A
A
Willenkin
R L
RL
D002982:Clinical Clerkship; D002983:Clinical Competence; D003422:Critical Care; D018592:Cross-Over Studies; D004501:Education, Medical; D004521:Educational Measurement; D006801:Humans; D007858:Learning; D011340:Problem Solving; D013663:Teaching / Q000379:methods