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Survey of current status of intensive care teaching in English-speaking medical schools

Shen, Judith MBBS; Joynt, Gavin M. MBBCh, FFA(SA); Critchley, Lester A. H. FFARCS, MD; Tan, Ian K. S. FFICANZCA, FANZCA, MRCP; Lee, Anna PhD, MPH

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Objective To identify a consensus of opinion regarding the content of an intensive care core syllabus for undergraduate medical students and factors that may limit its teaching.

Design Cross-sectional postal survey containing 35 items ranging from department structure to curriculum content and factors that limit the teaching of intensive care.

Setting English-speaking medical schools (n = 210) listed in the 1986 World Health Organization Directory.

Measurements and Main Results Of 122 (58%) returned questionnaires, a 45% return was achieved from the United States and 86% from non-U.S. countries. Most respondents (84%) considered teaching undergraduate intensive care to be essential; however, teaching intensive care was compulsory in only 31% of schools. Many schools (43%) reported recent changes to their intensive care curriculum. Most respondents (60%) thought that intensive care specialists should teach and that each student required a median (interquartile range) of 20 (10–80) hrs of teacher contact time. Resuscitation skills were taught in 98% of schools. In comparison, 63% of schools had no intensive care syllabus. More than 90% of respondents thought that the intensive care syllabus should include the following: cardiopulmonary resuscitation, assessment and management of the acutely ill patient; management of respiratory, circulatory, and multiple organ system failure (including systemic inflammatory response syndrome and sepsis); management of the unconscious patient; early postoperative care; and communication skills and ethics as they relate to end-of-life issues. Factors that limited intensive care teaching were lack of staff, funding, and time dedicated to teaching and excessive clinical workload. Student performance in intensive care was assessed by 66% of schools, but only 28% used a written or oral examination.

Conclusions By surveying a wide range of medical schools internationally, we have been able to define an undergraduate intensive care syllabus that could be delivered in 20 hrs or 1 wk of dedicated teaching time. Factors that impede the provision of undergraduate intensive care teaching are a lack of staff, funding, and dedicated teaching time.

From the Chinese University of Hong Kong, the Department of Anaesthesia and Intensive Care, Prince of Wales Hospital, Shatin, NT Hong Kong (GMJ, LAHC, AL); and the Department of Anaesthesia & IC, Pamela Youde Nethersole Hospital, Chai Wan, Hong Kong (JS, IKST), Peoples Republic of China.

Funded by the Department of Anaesthesia and Intensive Care, Chinese University of Hong Kong.

By surveying medical schools worldwide, we have been able to define a reference list of core intensive care topics. The main factors that impede the development of undergraduate teaching of intensive care are a lack of funding and academic time.

© 2003 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins