Early Introduction of Neurocritical Care Procedures in Medical Student Training
Weston Wright1, Paola Martinez1, Kevin Chen1, Kannan Freyaldenhoven1, Carlos Garcia Rodriguez1, Scott Martindale1, Jonathan Trout1
1UT Health San Antonio
Objective:
The aim of this study was to increase medical students’ awareness and interest in neurocritical care, to teach common critical care procedures and to assess procedural confidence before and after the workshop.
Background:
Medical students spend their first two years in the classroom. When they begin clinical rotations, they are often unprepared, unconfident, and apprehensive about their ability to assist in common procedures such as intubation, lumbar puncture, chest tube and central line placement.
Design/Methods:
This study contained 14 second-year medical students who were separated into four stations led by Neurocritical care faculty from the Neurology and Neurosurgery departments at The University of Texas Health Science Center at San Antonio. Faculty on each station discussed the risks, benefits and demonstrated the procedure on manikins. Students took turns performing each procedure under faculty guidance. Pre and post workshop surveys were distributed to medical students to evaluate workshop efficacy. Results were analyzed with a paired students’ T-Test.
Results:
Fourteen students completed both pre and post workshop surveys. Medical students’ self-reported confidence significantly increased in performing chest tube placement, intubation, and central line placement. On a 1-5 Likert Scale, self-reported confidence in intubation showed the largest improvement, with a mean score difference of 2.08 (95% CI [1.40 - 2.75]), p-value = 0.00002.149. Self-reported confidence in performing chest tube placement also significantly increased (p-value = 0.00004.374). Central line placement had the lowest score change, with a mean difference of 1.77 (95% CI [1.21 - 2.33]), p-value = 0.00001692. There was a significant increase in awareness of the field of neurocritical care with median score difference of 2 with a p-value of 0.000834.
Conclusions:
The critical care setting is a time-sensitive environment that requires knowledge, procedural skills and confidence. Introducing procedures early in a medical student’s training bolsters their knowledge of indications, risks and confidence in performing procedures during clinical rotations.