An evaluation of learning clinical decision-making for early rehabilitation in the ICU via interactive education with audience response system.
Knowledge-related barriers to safely implement early rehabilitation programs in intensive care units (ICUs) may be overcome via targeted education. The purpose of this study was to evaluate the effectiveness of an interactive educational session on short-term knowledge of clinical decision-making for safe rehabilitation of patients in ICUs.



A case-based teaching approach, drawing from published safety recommendations for initiation of rehabilitation in ICUs, was used with a multidisciplinary audience. An audience response system was incorporated to promote interaction and evaluate knowledge before vs. after the educational session.



Up to 175 audience members, of 271 in attendance (129 (48%) physical therapists, 51 (19%) occupational therapists, 31 (11%) nursing, 14 (5%) physician, 46 (17%) other), completed both the pre- and post-test questions for each of the six unique patient cases. In four of six patient cases, there was a significant (p< 0.001) increase in identifying the correct answer regarding initiation of rehabilitation activities. This learning effect was similar irrespective of participants' years of experience and clinical discipline.



An interactive, case-based, educational session may be effective for increasing short-term knowledge, and identifying knowledge gaps, regarding clinical decision-making for safe rehabilitation of patients in ICUs. Implications for Rehabilitation Lack of knowledge regarding the safety considerations for early rehabilitation of ICU patients is a barrier to implementing early rehabilitation. Interactive educational formats, such as the use of audience response systems, offer a new method of teaching and instantly assessing learning of clinically important information. In a small study, we have shown that an interactive, case-based educational format may be used to effectively teach clinical decision-making for the safe rehabilitation of ICU patients to a diverse audience of clinicians.
a Department of Physical Medicine and Rehabilitation , Johns Hopkins Hospital , Baltimore , MD , USA.|b Outcomes after Critical Illness and Surgery (OACIS) Group , Johns Hopkins University , Baltimore , MD , USA.
Amy L
AL
Toonstra
b Outcomes after Critical Illness and Surgery (OACIS) Group , Johns Hopkins University , Baltimore , MD , USA.|c Division of Pulmonary and Critical Care Medicine , Johns Hopkins University School of Medicine , Baltimore , MD , USA.
Archana
A
Nelliot
b Outcomes after Critical Illness and Surgery (OACIS) Group , Johns Hopkins University , Baltimore , MD , USA.|c Division of Pulmonary and Critical Care Medicine , Johns Hopkins University School of Medicine , Baltimore , MD , USA.
Lisa
L
Aronson Friedman
a Department of Physical Medicine and Rehabilitation , Johns Hopkins Hospital , Baltimore , MD , USA.|b Outcomes after Critical Illness and Surgery (OACIS) Group , Johns Hopkins University , Baltimore , MD , USA.|d Department of Physical Medicine and Rehabilitation , Johns Hopkins University School of Medicine , Baltimore , MD , USA.
Jennifer M
JM
Zanni
e Australian and New Zealand Intensive Care Research Centre, Monash University , Melbourne , Australia.|f Physiotherapy Department , The Alfred Hospital , Prahran , Australia.
Carol
C
Hodgson
b Outcomes after Critical Illness and Surgery (OACIS) Group , Johns Hopkins University , Baltimore , MD , USA.|c Division of Pulmonary and Critical Care Medicine , Johns Hopkins University School of Medicine , Baltimore , MD , USA.|d Department of Physical Medicine and Rehabilitation , Johns Hopkins University School of Medicine , Baltimore , MD , USA.
Dale M
DM
Needham
D000066491:Clinical Decision-Making; D003422:Critical Care / Q000379:methods*; D004521:Educational Measurement; D006282:Health Personnel / Q000193:education*; D006801:Humans; D007362:Intensive Care Units; D015397:Program Evaluation; D012046:Rehabilitation / Q000193:education* / Q000379:methods*; D000066908:Simulation Training; D013997:Time Factors
Critical care; decision-making; intensive care units; rehabilitation