The impact of adding 1 month of intensive care unit training in a categorical internal medicine residency program.
OBJECTIVE
To determine the impact of adding a month of critical care training in the postgraduate year (PGY)-2 on the critical care skills of PGY-3 residents.


METHODS
Prospective, nonrandomized.


METHODS
The internal medicine (IM) residency program of a tertiary care medical center.


METHODS
The study subjects included the 2005/2006 and 2006/2007 academic year IM residents.


METHODS
The 2005/2006 IM residents (control group, n = 48) had 1 month of critical care training (internship year) before their 1-month PGY-3 rotations. The 2006/2007 residents (intervention group, n = 47) had an additional 1-month rotation in a multispecialty intensive care unit (ICU) during their second year.


RESULTS
At the beginning of their last ICU month rotation, the intervention group's self-assessment (1-5 Likert scale) of their skills in internal jugular venous catheterization (3.4 vs. 2.4, p < 0.001) and management of severe sepsis (4.0 vs. 2.4, p < 0.001) and acute lung injury (3.3 vs. 2.6, p < 0.001) was higher than that of the control group. However, the observed success rates of endotracheal intubation (55.4% vs. 54.9%, p = 0.953) and central venous catheterization (78.1% vs. 80.8%, p = 0.488) were similar between the two groups. No difference was noted in the complication rates for endotracheal intubation or central venous catheterization between the control and intervention groups. End of ICU rotation examination results, attending evaluations, and the observed application of evidence-based practice in the management of severe sepsis were similar between the two groups.


CONCLUSIONS
Increasing IM residents' experience in the ICU resulted in modest, transient improvement of their perceived clinical skills in critical care procedures and management of severe sepsis and acute lung injury. However, no statistically significant and sustained improvement was noted in the observed cognitive or clinical skills.
Mullon
John J
JJ
Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA.
Gajic
Ognjen
O
Gali
Bhargavi
B
Ficalora
Robert D
RD
Kolars
Joseph C
JC
Afessa
Bekele
B
D000328:Adult; D003422:Critical Care; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D008297:Male; D011446:Prospective Studies; D013997:Time Factors