Building self-efficacy in medical trainees working in high stakes environment

Area of Science:

• Medical Education
• Critical Care Medicine
• Clinical Psychology

Background:

• Self-efficacy, an individual's belief in their capabilities, is crucial for effective ventilator management (VM) in intensive care units (ICUs).
• The specific training conditions that foster self-efficacy in VM among residents remain underexplored.
• This study investigates how ICU rotations influence residents' self-efficacy in VM.

Purpose of the Study:

• To examine final-year internal medicine residents' perceptions of factors influencing self-efficacy in ventilator management during ICU rotations.
• To identify specific conditions within the ICU training environment that facilitate or hinder the development of self-efficacy in VM.

Main Methods:

• Convergent parallel mixed-method study involving 20 internal medicine residents at Tan Tock Seng Hospital, Singapore.
• Quantitative data collected via the General Self-efficacy Scale and a custom VM self-efficacy proxy measure.
• Qualitative data gathered through focus group discussions analyzed using reflexive thematic analysis.

Main Results:

• Residents reported moderate to high general self-efficacy, with perceived availability of mastery experiences, vicarious learning, and positive affect.
• Social persuasion, particularly timely feedback, was perceived as limited.
• Qualitative findings revealed themes like 'Fear of the Vent,' countered by 'Reassuring Mentorship' and 'Work-Place Based Pedagogy,' enhancing self-efficacy.

Conclusions:

• Mentorship and workplace experiences are vital for building self-efficacy in ventilator management, even amidst initial apprehension.
• Active participation within the ICU training culture is essential for developing confident critical care clinicians.