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A Procedural Approach to Teaching Residents To Conduct Intensive Care Unit Family Conferences
Kathryn Whitaker1,2, Erin K Kross2,3, Catherine L Hough2
11 Internal Medicine Residency, Department of Medicine, University of Washington , Seattle, Washington.
Rationale:
Family conferences are an essential component of high-quality ICU care and an important skill for physicians. For residents, intensive care unit (ICU) rotations represent an opportunity to learn to conduct family conferences, and residents are already familiar with an approach for learning ICU procedures with steps of increasing responsibility organized as a module.
Objectives:
To determine the acceptability and feasibility of a procedure-training module for teaching family conferences.
Methods:
We conducted a feasibility pilot study of a family conference training module with residents during a one-month ICU rotation over a three-month period. The module had five components: (1) two-minute instructional video; (2) faculty observation of two family conferences; (3) standardized observation and formative evaluation; (4) online resident procedure log; and (5) family conference note template to document the conference in the medical record. We evaluated acceptability with an anonymous survey.
Results:
Twenty-seven residents rotated through the ICU during the pilot with 11 completing only one observed conference (41%) and 4 completing two or three observed conferences (15%). The most common reasons for not having conducted observed and evaluated conferences included competing work demands and conferences occurring at night. The survey response rate was 44% (12/27). Of respondents, 92% gave the module a rating of good, very good, or excellent and 92% stated they would recommend the module to others.
Conclusions:
This five-component module for teaching family conferences was rated as acceptable by most respondents, but significant barriers to successful implementation must be addressed before this is likely to be an effective teaching method.
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