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Time-efficient, goal-directed, and evidence-based teaching in the ICU

Brzezinski, Mareka; Kukreja, Jasleenb; Mitchell, John D.c

Current Opinion in Anesthesiology: April 2019 - Volume 32 - Issue 2 - p 136–143
doi: 10.1097/ACO.0000000000000702

Purpose of review Teaching in the stressful, high-acuity environment of the ICU is challenging. The intensivist-educator must use teaching strategies that are both effective and time-efficient, as well as evidence-based approaches to the ICU curriculum. This review provides an overview of pertinent educational theories and their implications on educational practices, a selection of effective teaching techniques, and a review on feedback.

Recent findings Evidence supports the role of conceptual frameworks in providing the educator with a key perspective to obtain a deeper understanding of the factors contributing to an effective and goal-directed education in the ICU. The role of simulation training for technical and nontechnical skills acquisition is growing. Feedback is difficult to provide, but critical to facilitate learner success; frameworks, and approaches are becoming more standardized.

Summary Direct teaching should be goal-oriented, sequential, and adjusted to the level of the learner. The ICU curriculum should optimize cognitive load, reduce stress that is unrelated to the activity, include resilience training, and help trainees deal with stressful clinical situations better. Simulation is a powerful tool to promote technical and nontechnical skills. Providing feedback is essential and a skill that can be taught and enhanced with structure, prompts, and tools.

aDepartment of Anesthesia and Perioperative Care

bDepartment of Surgery, University of California, San Francisco, San Francisco, California

cHarvard Medical School and Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA

Correspondence to Marek Brzezinski, MD, PhD, VA Medical Center, Anesthesiology Service (129), 4150 Clement Street, San Francisco, CA 94121, USA. Tel: +1 415 750 2069; e-mail:

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