The Impact of Overnight In-House Critical Care Resource Intensivist (CCRI) on Multidisciplinary Resident Education

IntroductionCritical care is a core component of resident education across multiple specialties. At this institution, nighttime supervision was previously provided by the on-call acute care surgeon. The CCRI model is a multidisciplinary team of fellowship trained intensivists who provide in-house overnight coverage. A prior study looked at the perceptions of general surgery residents on the impact of the CCRI model on education and patient care. This study expands our inquiry to compare the experience of residents across multiple specialties.MethodsAnonymous surveys were sent to anesthesiology (AN), emergency medicine (EM), internal medicine (IM), and general surgery (GS) residents using the Qualtrics platform. Demographic information included postgraduate year (PGY), specialty, and relationship to implementation of CCRI. 4-Point Likert Scale and free text questions were included.ResultsOf 138 total residents (16 AN, 46 EM, 51 IM, and 25 GS), 82 completed the survey (59.4%). Respondent stratification included 31 PGY-1 (38%), 22 PGY-2 (27%), 17 PGY-3 (21%), 6 PGY-4 (7%), 6 PGY-5 (7%); 11 AN (14%), 18 EM (22%), 29 IM (35%), and 24 GS (29%). Composites of strongly agree/agree show positive perception of attending availability (95%), improved patient care (98%), education (87%), and procedural skill (78%) and disagree/strongly disagree show negative perception of limiting autonomy (79%) or detracting from education (83%).ConclusionsThe CCRI model was implemented to enhance educational and clinical support of residents in the ICU overnight. Across multiple disciplines and training years, residents have indicated a favorable impact of the CCRI on education, clinical support, and procedural skill with no significant impairment to autonomy.