Improving skills and education in intensive care medicine

Francesca Rubulotta, Pascale Gruber


In the last decade two main undertakings have transformed education across all medical specialities, namely: (I) the introduction of teaching and assessing “soft skills”; (II) the global use of digital education and digitalised health care delivery. This review will look at the impact of these two events in teaching competencies in the field of intensive care medicine (ICM). ICM is a relatively new discipline and training in ICM is variable across Europe. The framework of competency based training in ICM in Europe has been defined by the Competency Based Training programme in ICM for Europe and outside regions (CoBaTrICE, in some countries and by local National Training Programs in others. There are also some European countries that still use traditional training methods and do not undertake competency based training. Whilst traditional training methods have been criticized, the implementation of competency based training has never been followed by international research to prove its benefit. In the CoBaTrICE curriculum, there are several competences that relate to professionalism, leadership and soft skills. Communication, professionalism, negotiation and team working are all essential skills to the intensive care doctor. This review will suggest new methodologies and areas for development in teaching and assessing soft skills. The digital era represents the second challenge in education in ICM. Learning with the aid of technology seems beneficial and this might relate to the fact that adults learn (andragogy) best using spontaneous learning. Digital education mediated by several tools (blogs, webinars, social media) can facilitate spontaneous learning and thus adult education. Challenges of digitalised education are related to quality control issues, rapid adoption of literature into clinical practice without the presence of a systematic rigorous peer review process. Finally, research has highlighted the benefit of technologies that help clinicians to manage the exponential growth in medical information. Clinical decision support systems (CDSSs) can improve the quality of patient care and improve patient safety. This review will explore improvements and projects relating to use of CDSSs in the field of ICM.