Clinical course teaching in transport of critically ill patients: Small group methods

  • Mohammad Taghi Beigmohammadi Department of Anesthesiology and Intensive Care, Tehran University of Medical Sciences, Tehran, Iran.
  • Mojgan Rahimi Department of Anesthesiology and Intensive Care, Tehran University of Medical Sciences, Tehran, Iran.
  • Omid Nabavian Department of Anesthesiology and Intensive Care, Tehran University of Medical Sciences, Tehran, Iran.
  • Seyed Hossein Davarani Department of Emergency, Tehran University of Medical Sciences, Tehran, Iran.
  • Kassra Karvandian Department of Anesthesiology and Intensive Care, Tehran University of Medical Sciences, Tehran, Iran.
  • Fatemeh Kamalitabar Department of Educational Psychology, Member of Society of Psychology of Iran, Tehran, Iran.
Keywords: Teaching, Clinical competence, Patient transfer, Critical illness

Abstract

Critically ill patient transfer is potentially risky and may be lead to morbidity and mortality. Physicians' skill is very important for safe transport. We want to evaluate the effect of clinical course teaching on the promotion of physicians' abilities in the transport of critically ill patients. In an interventional study, 320 interns, male and female, were taught about patient transfer in two groups include in one day clinical course as the small group system (n=160) and other group the lecture base learning (n=160). In the clinical course, each participant under observation of an anesthesiologist in the operation room and ICU was acquainted with mask ventilation, intubation and learned to work with a defibrillator, infusion pump, portable ventilator and pulse oximeter. In lecture group, the anesthesiologist explained the topics by video and dummy. At the end of education course, the interns’ abilities were evaluated based on checklist method and scored by the project colleague in all educational items. Three hundred twenty interns, 122 males, and 198 females; were enrolled, two groups. The clinical course training caused improvements in the interns’ knowledge and abilities in intubation and use of the defibrillator and portable ventilator vs.lecture group significantly (P<0.005). The males were better than females in laryngoscopy, but the progress of the females was significantly better than males (P=0.003). The rate of adverse events was reduced significantly after clinical course teaching (P=0.041) Clinical course teaching could promote interns' clinical competencies in the transport of critically ill patients.

References

- Warren J, Fromm Jr R E, Orr R A, Rotello L C, Horst H M. Guidelines for the inter- and intrahospital transport of critically ill patients. Crit Care Med 2004, 32: 256-262.

-Fanara B, Manzon C, Barbot O, Desmettre T, Capellier G. R: Recommendations for the intra-hospital transport of critically ill patients. Crit Care 2010, 14:R87.

- Dunn M J G, Gwinnutt C L, Gray A J. Critical care in the emergency department: patient transfer. Emerg Med J 2007;24:40–44.

- Droogh J M, Smit M, Hut J, Vos R de, Ligtenberg J J M, Zijlstra J G. Inter-hospital transport of critically ill patients;expect surprises.Crit Care 2012, 16:R26.

- Fan E, MacDonald R D, Adhikari N KJ, Scales D C, Wax R S, Stewart T E, Ferguson N D.Outcomes of interfacility critical care adult patient transport: a systematic review. Crit Care 2006, 10:R6.

-Papson JP, Russell KL, Taylor DM: Unexpected events during the intrahospital transport of critically ill patients. Acad Emerg Med 2007, 14:574-577.

-Stevenson VW, Haas CF, Wahl WL: Intrahospital transport of the adult mechanically ventilated patient. Respir Care Clin N Am 2002, 8:1-35.

-Gillman L, Leslie G, Williams T, Fawcett K, Bell R, McGibbon V: Adverse events experienced while transferring the critically ill patient from the emergency department to the intensive care unit. Emerg Med J 2006, 23:858-861.

-Tice P: Intrahospital transport of critically ill adults: potential physiologic changes and nursing implications. Focus Crit Care 1991, 18:424-428.

-Lahner D, Nikolic A, Marhofer P, Koinig H, Germann P, Weinstabl C, Krenn CG: Incidence of complications in intrahospital transport of critically ill patients--experience in an Austrian university hospital. Wien Klin Wochenschr 2007, 119:412-416.

-Damm C, Vandelet P, Petit J, Richard JC, Veber B, Bonmarchand G, Dureuil B: [Complications during the intrahospital transport in critically ill patients]. Ann Fr Anesth Reanim 2005, 24:24-30.

-Lovell MA, Mudaliar MY, Klineberg PL: Intrahospital transport of critically ill patients: complications and difficulties. Anaesth Intensive Care 2001,29:400-405.

-Shirley PJ, Stott SA: Clinical and organisational problems in patients transferred from the intensive care unit to other areas within the hospital for diagnostic procedures. B J Anaesth 2001, 87:346-347.

-Doring BL, Kerr ME, Lovasik DA, Thayer T: Factors that contribute to complications during intrahospital transport of the critically ill. J Neurosci Nurs 1999, 31:80-86.

-Beckmann U, Gillies DM, Berenholtz SM, Wu AW, Pronovost P: Incidents relating to the intra-hospital transfer of critically ill patients. An analysis of the reports submitted to the Australian Incident Monitoring Study in Intensive Care. Intensive Care Med 2004, 30:1579-1585.

-Walton H. Small group methods in medical teaching. Med Educ 1997, 31:459-464.

- Nieder G L, Parmelee D X, Stolfi A, Hudes P D. Team-Based Learning in a Medical Gross Anatomy and Embryology Course. Clin Anat 2005, 18:56–63.

-Bercault N, Wolf M, Runge I, Fleury JC, Boulain T: Intrahospital transport of critically ill ventilated patients: a risk factor for ventilator-associated pneumonia--a matched cohort study. Crit Care Med 2005, 33:2471-2478.

- Hopkins P, Wolff A H. Intensive care transfers. Critical Care 2002, 6:123-124

- Marx G, Vangerow B, Hecker H, Leuwer M, Jankowski M, Piepenbrock S, Rueckoldt H: Predictors of respiratory function deterioration after transfer of critically ill patients. Intensive Care Med 1998, 24:1157-1162.

Published
2016-10-31
How to Cite
1.
Beigmohammadi MT, Rahimi M, Nabavian O, Davarani SH, Karvandian K, Kamalitabar F. Clinical course teaching in transport of critically ill patients: Small group methods. Acta Med Iran. 54(9):590-594.
Section
Articles