Interprofessional Education Module on Post-Intensive Care Syndrome for Internal Medicine Residents

Abstract

Background: Prevention of post-intensive care syndrome (PICS) in critically ill patients requires interprofessional collaboration among physicians, physical therapists, occupational therapists, speech-language pathologists, and nutritionists. Interprofessional education promotes interprofessional collaborative practice, yet formalized interprofessional education during residency is uncommon.

Objective: We sought to improve internal medicine residents' knowledge of interprofessional roles in the intensive care unit (ICU) and confidence in managing PICS by designing a virtual multimodal training module.

Methods: We created a 3-hour virtual module with physical therapy, occupational therapy, speech-language pathology, and nutrition experts. First, learners reviewed PICS and multidisciplinary interventions to optimize patient recovery. Second, attendees watched videos created by physical therapy and occupational therapy colleagues demonstrating mobility strategies to manage ICU-acquired weakness and delirium. Third, participants learned how speech-language pathology experts evaluate and manage swallowing disorders. Finally, attendees identified common nutritional therapy challenges with a trivia session. Participants completed pre- and postcourse assessments.

Results: Thirty-four residents completed both pre- and postcourse assessments (52% response rate). The mean objective assessment score improved from 51% to 79% (P < 0.001). All respondents reported that their knowledge of PICS increased, and almost all (97%) believed that their knowledge of interprofessional roles increased. Respondents' confidence in facilitating discussions about critical illness recovery significantly improved, from 77% rating as either not very confident or not at all confident before the course to 94% rating as somewhat confident or very confident after the course (P < 0.001).

Conclusion: This single-site pilot study suggests that integrating interprofessional training in PICS education using virtual platforms may improve residents' knowledge of interprofessional roles in the ICU and confidence in managing PICS.

Keywords: interprofessional collaborative practice; curriculum; graduate medical education; intensive care; interprofessional education.

Figure 1.

Representation of the roles of physicians and therapists in the care of critically ill patients. Physicians often focus on diagnosing and managing underlying disease states, which leads to systemic inflammation and may require prolonged sedation and immobilization. Both processes may result in weakness, neuropsychiatric dysfunction, and malnutrition, which are often addressed by therapists in the care of critically ill patients.

Figure 2.

Pre- and postcourse assessment comparison of the number of multiple-choice questions (out of five total) answered correctly by respondents (n = 34). On the precourse assessment, 53% of respondents answered three or four questions correctly and no participants answered five questions correctly. On the postcourse assessment, 91% of respondents answered at least three questions correctly.

Figure 3.

Pre- and postcourse assessment comparison of attendees’ confidence in their ability to facilitate discussions with patients and families about their expectations for recovery from critical illness (P < 0.001).