INTRODUCTION: A 2-year residency must prepare family physicians to provide a broad range of services. In many settings, especially rural and remote practices, family physicians provide emergency and inpatient care and thus encounter critically ill patients. Evidence of the importance of early recognition and aggressive intervention in critical illness is growing. However, opportunities to safely practise critical care skills during residencies are limited. METHODS: The 2-day Acute Critical Events Simulation (ACES) course was offered to all family medicine residents at the University of Ottawa in 2009. The course included lectures, case discussions, hands-on task training and a half-day of high-fidelity simulation. Its aims were to enhance the abilities of residents in family medicine to recognize signs of critical illness, to teach competencies in the early resuscitation and care of such patients, and to increase residents' confidence to include inpatient and emergency care in their practices, or to practise in a rural or remote setting. A postcourse questionnaire, which included Likert-scale and open-ended questions, was distributed to all participants. RESULTS: Thirty-seven participants completed the survey. The ACES course was exceptionally well-received by participants, who reported increases in confidence and perceived competence, as well as intentions to change practice. The course appeared to increase participants' confidence to work in rural or remote areas and include inpatient or emergency medicine services in their practices. CONCLUSION: The ACES course achieved its aims, and participants reported positive outcomes. This highly interactive, simulation-based program may help prepare residents for work in rural or remote communities with critically ill patients.
INTRODUCTION: A 2-year residency must prepare family physicians to provide a broad range of services. In many settings, especially rural and remote practices, family physicians provide emergency and inpatient care and thus encounter critically illpatients. Evidence of the importance of early recognition and aggressive intervention in critical illness is growing. However, opportunities to safely practise critical care skills during residencies are limited. METHODS: The 2-day Acute Critical Events Simulation (ACES) course was offered to all family medicine residents at the University of Ottawa in 2009. The course included lectures, case discussions, hands-on task training and a half-day of high-fidelity simulation. Its aims were to enhance the abilities of residents in family medicine to recognize signs of critical illness, to teach competencies in the early resuscitation and care of such patients, and to increase residents' confidence to include inpatient and emergency care in their practices, or to practise in a rural or remote setting. A postcourse questionnaire, which included Likert-scale and open-ended questions, was distributed to all participants. RESULTS: Thirty-seven participants completed the survey. The ACES course was exceptionally well-received by participants, who reported increases in confidence and perceived competence, as well as intentions to change practice. The course appeared to increase participants' confidence to work in rural or remote areas and include inpatient or emergency medicine services in their practices. CONCLUSION: The ACES course achieved its aims, and participants reported positive outcomes. This highly interactive, simulation-based program may help prepare residents for work in rural or remote communities with critically illpatients.
Authors: Amanda M Drost-de Klerck; Tycho J Olgers; Evelien K van de Meeberg; Johanna Schonrock-Adema; Jan C Ter Maaten Journal: BMJ Open Date: 2020-07-06 Impact factor: 2.692