Interprofessional education for residents rotating in the pediatric intensive care unit: a needs analysis
Creators: name: Lepage-Farrell, Alex
name: Richard, Amélie
name: Pinard, Anne Marie
Publisher: name: F1000 Research Limited
Year: 2023

description: <i><b>Introduction</b></i>: The intensive care unit (ICU) is where the most acutely ill patients are hospitalized and taken care of by interprofessional teams, who must collaborate every day to provide high-quality care. Interprofessional collaboration (IPC) is essential for healthcare workers in the intensive care unit. To collaborate effectively, doctors must be trained during medical school. Unfortunately, training is uneven across residency and allied health training programs. <br> <br> <b><i>Methods</i></b>: The objectives of this project are to explore the collaborative training needs of pediatric residents at the University of Montreal, a large program in Canada, and then to make recommendations for the development of future training activities. First, a specific questionnaire was sent to the target population (residents, doctors, nurses, respiratory therapists, pharmacists; all working in the pediatric intensive care unit at the CHU Sainte-Justine), to precisely explore the participants’ experience with collaborative training and IPC. Thereafter, participants were selected amongst the questionnaire-takers to take part in focus group discussions, to further elaborate about collaboration in training and in practice. This mixed-method study project explores the perception of collaboration of the residents and their colleagues, as well as the barriers and facilitators to training, particularly in the context of the pediatric intensive care rotation. <br> <br> <b><i>Results</i></b>: A total of 54 healthcare workers answered the survey, from multiple professional groups (resident doctors, pediatric intensivists, clinical fellows, respiratory therapists, nurses, and pharmacists). We noted a significant difference between interprofessional education (IPE) received by resident doctors and their staff. We then enrolled a total of 18 participants in the qualitative part of the project. Several themes emerged from the interview process, the first of which was the challenges faced by the participants. The residents faced challenges around their dual identity as trainees and providers, feeling like they are excluded from the team, and exposition discontinuity. The physician-teachers described challenges around fostering good collaborative practices, delivering evaluation specifically on interpersonal skills, and meeting the residents competing training needs. The allied health professionals talked about how hard it was to work with new teammates every month and how the lack of protected time to teach limited their involvement with the trainees. We also found factors that enable collaborative practice, mainly sharing the same definition of what is collaborative practice, bidirectional communication, and equality amongst team members. Finally, the participants described barriers to future training initiatives, including organizational factors, the residents competing interests and teaching needs, the lack of fitting teaching opportunities on the unit, and the need for explicit teaching on collaboration. <br> <br> <b><i>Discussion and conclusions</i></b>: Overall, we discussed the multiple challenges expressed by the participants, mainly evolving around role clarification for the resident, support for the educators, and involvement of the healthcare professionals in teaching and evaluation. We identified some interventions that might be useful. The residents might benefit specifically from early role clarification and their inclusion in the already existing interprofessional simulation activities. The physician-teachers would benefit from continuing medical education on teaching collaboration and evaluation, as well as including the allied health professional in the community of clinical educators. Finally, the professionals who are involved in residents teaching should get more recognition and allotted time to participate in teaching activities. In conclusion, the perception of collaboration was similar amongst the participants. Most recognized its importance and were motivated to work together. Despite the competing interests of all groups, we believe that, with creativity, new initiatives can be created and could significantly impact patient care.