The purpose of this survey was to identify current practices in fellow orientation procedures.
A 10 question survey was sent via email to current pulmonary and critical care medicine program directors identified in the American Thoracic Society (ATS) web registry. The survey sought to identify common characteristics of fellow orientation programs including duration, content and educational methods.
Of the 141 deliverable email addresses, 87 responded (61.7%). Of the programs who responded, 86% had a formal fellows’ orientation. The mean time frame spent in fellow orientation was 5-10 hours in didactic sessions and 0-5 hours in wet labs. Only twenty-four programs (28%) spent more than 15 hours in didactic sessions while no programs spent more than 15 hours in wet labs. The most common didactic topics were bronchoscopy in 69 programs (80.2%), pulmonary function testing in 63 programs (73.3%) and orientation to hospital services in 63 programs (73.3%). The least commonly covered topics were moderate/deep sedation in 38 programs (44.2%) and intubation in 39 programs (45.3%). The most common use of wet labs was for bronchoscopy training in 60 programs (81.1%) and ventilator management in 45 programs (60.8%). Thirty-seven responding programs (43%) used simulators in fellow orientation. The most frequently used simulator was a bronchoscopy simulator in 31 programs (36%). The majority of program directors did not offer formal wet lab or simulator training, relying instead on on-the-job training experiences during their fellowship.
This survey demonstrates that early fellowship training experiences differ across programs in terms of duration, content and methodology. Given the variability in skill level exhibited by entering fellows and understanding the importance of procedural competence to patient safety, an early standardized approach to clinical and procedural training can assure that entering fellows possess the requisite cognitive and psychomotor skills to safely embark on training in the critical care arena.
Establishing competency earlier in fellow training, has the potential to decrease medical errors and procedure related complications.
Maria Lucarelli, None.