Specialty trainee-led intensive care unit induction

Junior doctors from varied medical specialties are increasingly undertaking placements in intensive care units (ICUs). They may have minimal previous experience in the provision of advanced organ support, yet may have high levels of clinical responsibility. Traditional ICU induction has been consultant led, and has focused on local procedures and policies. A survey of trainees highlighted low levels of preparedness and confidence at managing advanced organ support, and dissatisfaction with the existing induction format.

Based on survey feedback and personal experience, a focus group of specialty trainees identified five core topics to be covered in a half-day of interactive lecture-based teaching presentations and a trainee handbook. A systems-based approach to advanced organ support and ICU emergencies was adopted. In cycle 2, formal written pre- and post-induction exams provided a more objective assessment of knowledge.

Two cycles of the new induction programme were delivered during consecutive junior doctor intakes, and yielded improved satisfaction and improved self-assessed confidence in routine and emergency management of advanced organ support and in the understanding of the principles of advanced organ support.

Specialty trainee-led induction may be better tailored to the needs of incoming junior doctors. This study demonstrated increased trainee satisfaction with induction and provided a legacy of teaching opportunity within the department, highlighting the potential for our near-peer model of induction. Safe and effective induction is paramount in the high-stakes ICU environment, but the principles described may also be transferrable to other clinical specialties. Traditional ICU induction has been consultant let, and has focused on local procedures and policies.