Objective: Multiple fellowships rotate through the cardiac intensive care unit (CICU), and each has different educational goals for the rotation. Faculty may find it challenging to understand the individual fellow’s learning needs within each subspecialty. Due to variation of patients and surgeries during a fellow’s rotation, they may not be exposed to all areas of cardiac critical care, and they may not be aware of their knowledge gaps. To improve the educational experience in our CICU and to better target the needs of each fellowship, we completed a needs assessment of our current educational system.
Methods: A survey was administered via Redcap to the current fellows and recent alumni of the Critical Care, Cardiology and Neonatology fellowships and the faculty in the CICU at our large, academic children’s hospital. The surveys contained questions in three areas: demographics, quality of education in the CICU, and rating of specific topics. The topics were chosen based on the American Board of Pediatrics content specifications for all three fellowships.
Results: There was a 65% (47/72) response rate for the survey with similar rates across the different subspecialties and faculty. Fellows had completed a median of 6 (IQR 4-10) weeks in the CICU prior to the survey. On a scale of 5 from Very Poor to Excellent, the median rating for the current educational experience in the CVICU was “Good” (IQR “Average” to “Good”) with each group having varying level of satisfaction (Figure 1). Most trainees disagreed that they had a clear understanding of their learning needs while rotating in the CICU and that the faculty targeted teaching toward gaps in their knowledge base (Figure 2). Most of the faculty disagreed that they were able to identify and keep track of each fellow’s learning needs (Figure 2). The two most identified barriers to learning in the CICU were lack of defined learning objectives (identified by 61% fellows/alumni and 67% faculty) and inadequate time (identified by 63% fellows/alumni and 67% faculty). Most of the trainees agreed that the knowledge and skills gained during their CICU rotation are important to their future career plans (Agree/strongly agree: Neonatology 6/10 (60%), Cardiology 7/9 (78%), Critical Care 11/15 (73%)). Regarding specific topics, some were rated highly across all 3 subspecialties (e.g. Identification and management of critical heart disease) while others had a wide range between the subspecialties (e.g. transplant post-op care was rated highly by Cardiology but rated low by Neonatology) (Topic ratings summarized in Table 1).
Conclusion: While all three fellowships reported that the skills and knowledge they acquire in the CICU are important to their future careers, they indicated that the education could be improved. Based on the barriers to learning identified from this survey, we plan to implement a “CICU Passport.” The passport will be customized for each fellowship and contain topics based on the rating scores from this survey to target the specific needs of each fellowship program. We anticipate that the “CICU Passport” will help the fellows keep track of their learning, help the faculty address specific knowledge gaps, and improve the overall satisfaction of the fellows in the CICU.
