Clinical Teaching in the Intensive Care Unit: Evaluation of the Perception of Trainees and Physicians

Background: The education of trainees in the intensive care unit (ICU) is extremely challenging due to factors related to the ICU environment, ICU trainees and physicians, ICU subspecialty training, and safety and quality of care delivered to critically ill patients. There is a lack of standardized educational curricula and instructional methods for teaching in the ICU. The teaching practices, the learning climate, the instructional methods, and obstacles to learning and teaching in the ICU have not been evaluated. Purpose: The main aim of this study was to evaluate the teaching practices, the learning climate, the ICU environment, the preferred instructional methods, and obstacles to learning and teaching in the ICU from the perspectives of learners (trainees) and teachers (physicians). Methods: A survey was conducted using the Maastricht clinical teaching questionnaire and supplementary questions in a medical school in South Texas. Data were collected from ICU learners and teachers and were analyzed using ANOVA and multiple comparison procedures. Results: Learners rated the teaching practices and learning climate in the ICU significantly lower than teachers in all categories of the Maastricht clinical teaching questionnaire. Learners and teachers recognized the ICU environment as ideal to learn and teach complex clinical cases and to enhance procedural skills. Most teachers indicated bedside teaching and case-based learning as the preferred instructional methods while learners indicated a combination of methods as the preferred instructional strategy in the ICU. The main obstacle for learners was unclear expectations and objectives of the ICU rotation. The main obstacle for teachers was not enough time for teaching. Conclusion: A disparity of perceptions existed between ICU trainees and physicians regarding the teaching practices and learning climate in the ICU. The preferred instructional methods for trainees are to use different instructional strategies. The ICU environment has many challenges for learners and teachers.