Bedside teaching in intensive care: effect on attitudes and skills of fourth-year medical students
© BioMed Central Ltd 2006
Published: 21 March 2006
A shortfall of intensivists in the future is expected. Therefore increasing interest early in the medical training could increase the number of ICU trainees. In addition many medical students have no clear image of what intensive care is all about. Although an orientation in the ICU is part of many medical school curricula worldwide, little is known on the impact of these programs.
Materials and methods
Fourth-year medical students attended a 2-hour bedside teaching course in intensive care where observation, hemodynamics and organ support were the main topics. Nurses and medical staff participated actively in the course. All students (n = 193, 135 females) attended the program and 192 students completed pre-course and post-course 5-point Likert questionnaires (scale 1 = strongly disagree to 5 = strongly agree). Data are presented as the mean ± SD. The Mann-Whitney test was used to compare responses before and after the teaching program. P < 0.05 was considered statistically significant.
Overall attitudes towards the ICU as well as self-reported skills improved significantly following the course. Interest to qualify as an intensivist increased significantly (P = 0.002). Also fewer students pictured the ICU as a typical drama-series ICU following the course (P < 0.001). In addition the students felt they could better describe the organization and structure of the ICU team following the course (2.9 ± 0.8 vs 4.0 ± 0.6, P < 0.001). The self-reported ability to identify and qualify organ failure and hemodynamics improved significantly, i.e. the ability to calculate the mean arterial pressure increased from 2.9 ± 1.1 to 4.3 ± 0.9 (P < 0.001). Students reported no emotional/coping problems associated with the visit to severely ill patients. One medical student was involved in acute circulatory arrest of a patient. The majority of the nurses were positive on the involvement in this training program and also the burden to their day-to-day clinical work in relation to the experienced positive effect was limited.
A 2-hour ICU orientation in the undergraduate curriculum based on adult learning principles was successful in increasing interest for the profession, improving understanding of the ICU organization as well as improving the ability to recognize vital organ functions and principles of the monitoring of critically ill patients.