Increasing Internal Medicine Resident Confidence in Leading Inpatient Cardiopulmonary Resuscitations and Improving Patient Outcomes
Introduction: Residents do not feel confident or competent in leading inpatient resuscitations. This is a crucial part of training future internists. Our objective was to develop a low-cost intervention to improve resident confidence in leading cardiopulmonary resuscitations and patient outcomes. Me...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2020-05-01
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| Series: | Journal of Medical Education and Curricular Development |
| Online Access: | https://doi.org/10.1177/2382120520923716 |
| _version_ | 1818454535372275712 |
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| author | Nathan T Douthit Christine M McBride Erin Coleman Townsley |
| author_facet | Nathan T Douthit Christine M McBride Erin Coleman Townsley |
| author_sort | Nathan T Douthit |
| collection | DOAJ |
| description | Introduction: Residents do not feel confident or competent in leading inpatient resuscitations. This is a crucial part of training future internists. Our objective was to develop a low-cost intervention to improve resident confidence in leading cardiopulmonary resuscitations and patient outcomes. Methods: A “code-conference” including a lecture on a high-yield topic, a low-fidelity simulation, and review of resident-led resuscitations was created at our institution for the 2017-2018 academic year. Patient outcomes were assessed using objective measures of return of spontaneous circulation (ROSC) and survival to discharge (sDC). Confidence was assessed via survey before and after the intervention, with a focus on beginning postgraduate year 2 (PGY-2) residents. Results: In 2017, 8 out of 8 (100%) PGY-2 residents responded, while in 2018, 8 out of 10 (80%) responded. Patient outcomes did not show a statistically significant improvement. There was a trend toward positive outcomes in the resident group alone. Return of spontaneous circulation increased from 63% to 79% ( P = .08, total n = 97). Resident confidence was not improved in a statistically significant way, but there was a trend toward improvement and residents agreed it was an important part of their training. Discussion: There was no statistically significant improvement in code-blue outcomes; however, there was a positive trend with increased ROSC and stable sDC for resident-led resuscitations, despite hospital-wide decreases in both. Resident confidence also showed a positive trend with no statistical significant changes. It is possible to institute a low-cost high-yield intervention to improved resident confidence in leading code-blue resuscitations. It may also improve patient outcomes; however, further studies are needed to determine if it can improve patient survival outcomes. |
| first_indexed | 2024-12-14T21:56:25Z |
| format | Article |
| id | doaj.art-0815318bea5f4afe92184206ac4b07ea |
| institution | Directory Open Access Journal |
| issn | 2382-1205 |
| language | English |
| last_indexed | 2024-12-14T21:56:25Z |
| publishDate | 2020-05-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Medical Education and Curricular Development |
| spelling | doaj.art-0815318bea5f4afe92184206ac4b07ea2022-12-21T22:46:06ZengSAGE PublishingJournal of Medical Education and Curricular Development2382-12052020-05-01710.1177/2382120520923716Increasing Internal Medicine Resident Confidence in Leading Inpatient Cardiopulmonary Resuscitations and Improving Patient OutcomesNathan T Douthit0Christine M McBride1Erin Coleman Townsley2Department of Internal Medicine, Brookwood Baptist Health Medical Education, Birmingham, AL, USAThe Edward Via College of Osteopathic Medicine, Auburn, AL, USAInternal Medicine Residency, Brookwood Baptist Health Medical Education, Birmingham, AL, USAIntroduction: Residents do not feel confident or competent in leading inpatient resuscitations. This is a crucial part of training future internists. Our objective was to develop a low-cost intervention to improve resident confidence in leading cardiopulmonary resuscitations and patient outcomes. Methods: A “code-conference” including a lecture on a high-yield topic, a low-fidelity simulation, and review of resident-led resuscitations was created at our institution for the 2017-2018 academic year. Patient outcomes were assessed using objective measures of return of spontaneous circulation (ROSC) and survival to discharge (sDC). Confidence was assessed via survey before and after the intervention, with a focus on beginning postgraduate year 2 (PGY-2) residents. Results: In 2017, 8 out of 8 (100%) PGY-2 residents responded, while in 2018, 8 out of 10 (80%) responded. Patient outcomes did not show a statistically significant improvement. There was a trend toward positive outcomes in the resident group alone. Return of spontaneous circulation increased from 63% to 79% ( P = .08, total n = 97). Resident confidence was not improved in a statistically significant way, but there was a trend toward improvement and residents agreed it was an important part of their training. Discussion: There was no statistically significant improvement in code-blue outcomes; however, there was a positive trend with increased ROSC and stable sDC for resident-led resuscitations, despite hospital-wide decreases in both. Resident confidence also showed a positive trend with no statistical significant changes. It is possible to institute a low-cost high-yield intervention to improved resident confidence in leading code-blue resuscitations. It may also improve patient outcomes; however, further studies are needed to determine if it can improve patient survival outcomes.https://doi.org/10.1177/2382120520923716 |
| spellingShingle | Nathan T Douthit Christine M McBride Erin Coleman Townsley Increasing Internal Medicine Resident Confidence in Leading Inpatient Cardiopulmonary Resuscitations and Improving Patient Outcomes Journal of Medical Education and Curricular Development |
| title | Increasing Internal Medicine Resident Confidence in Leading Inpatient Cardiopulmonary Resuscitations and Improving Patient Outcomes |
| title_full | Increasing Internal Medicine Resident Confidence in Leading Inpatient Cardiopulmonary Resuscitations and Improving Patient Outcomes |
| title_fullStr | Increasing Internal Medicine Resident Confidence in Leading Inpatient Cardiopulmonary Resuscitations and Improving Patient Outcomes |
| title_full_unstemmed | Increasing Internal Medicine Resident Confidence in Leading Inpatient Cardiopulmonary Resuscitations and Improving Patient Outcomes |
| title_short | Increasing Internal Medicine Resident Confidence in Leading Inpatient Cardiopulmonary Resuscitations and Improving Patient Outcomes |
| title_sort | increasing internal medicine resident confidence in leading inpatient cardiopulmonary resuscitations and improving patient outcomes |
| url | https://doi.org/10.1177/2382120520923716 |
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