SESSION TYPE: Teaching of Procedures
PRESENTED ON: Tuesday, October 23, 2012 at 04:30 PM - 05:45 PM
PURPOSE: The frequency of pulmonary artery catheterization procedures has decreased significantly since the early 1990s. It is unknown whether current pulmonary and critical care fellows continue to have adequate opportunity during fellowship training to learn to place pulmonary artery catheters and interpret their results.
METHODS: All pulmonary and critical care program directors were invited by email to participate in an anonymous and voluntary online survey regarding current training opportunities in pulmonary artery catheter placement and interpretation in their fellowship programs.
RESULTS: The response rate was 51% (69/136 program directors). 83% of respondents reported that the number of pulmonary artery catheterization procedures performed by fellows within their training program has decreased in the past decade. 55% of program directors estimated that their fellows currently participate in fewer than 10 supervised pulmonary artery catheterization procedures during fellowship training. Training programs in which fellows performed fewer than 10 supervised procedures during fellowship were significantly more likely to report that services other than pulmonology perform the majority of procedures for the evaluation of pulmonary hypertension (48% vs. 6%, p=0.0005). Program size was not associated with opportunity to train in pulmonary artery catheterization (p=0.71). The most frequently identified barrier to training in pulmonary artery catheterization was procedure volume (identified as important by 82% of respondents). Only half of program directors agreed that training is currently adequate within their program in pulmonary artery catheter placement (43%) and/or data interpretation (55%). While 81% of respondents agreed that proficiency in pulmonary artery catheterization data interpretation should be an ACGME requirement for graduation from pulmonary and critical care fellowship, only 39% agreed that proficiency in catheter placement should be a requirement.
CONCLUSIONS: Many current pulmonary and critical care fellows do not have the opportunity to gain proficiency in pulmonary artery catheterization during standard fellowship training, likely due to decreased procedure volume.
CLINICAL IMPLICATIONS: This study raises questions about whether proficiency in pulmonary artery catheter placement and interpretation should continue to be an ACGME requirement.
DISCLOSURE: The following authors have nothing to disclose: Melissa Tukey, Renda Wiener
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