Resident and Nurse Education in Pediatric Intensive Care Unit

  • Girish G. Deshpande
  • Gwen J. Lombard
  • Adalberto TorresJr.


In the current age of exponential increase in medical knowledge, advances in technology, and electronic data gathering, education of resident physicians and nurses in Pediatric Intensive Care is imperative. Resident physicians are spending less time caring for critically ill patients due to restricted work hours, mandatory didactics attendance and continuity clinics. Attending physicians have less protected time dedicated to education due to administrative and research demands. Nurses working in Pediatric Intensive Care are required to possess extensive clinical skills that are increasingly complex. Educators need to explore new avenues of providing training to both resident physicians and nurses. Using different modalities of simulation appears to be the most appealing solution by providing necessary training in safe and effective environment. This chapter explores several different avenues of improving education in Pediatric Intensive Care.


Resident Education Nurse Education Pediatric Intensive Care Unit Web-based education Simulation training Factors impacting resident education 


  1. 1.
    Dreyfus HL, Dreyfus SE. Mind over machine: the power of human intuition and expertise in the era of the computer. New York: The Free Press; 1986.Google Scholar
  2. 2.
    Brenner P. From novice to expert: excellence and power in clinical nursing practice. Upper Saddle River: Prentice Hall Health; 2001.Google Scholar
  3. 3.
    ACGME Program Requirements for GME in Pediatrics July 1, 2007. Last accessed 28 Jan 2012.
  4. 4.
    Chudgar SM, Cox CE, Que LG, et al. Current teaching and evaluation methods in critical care medicine: has the Accreditation Council for Graduate Medical Education affected how we practice and teach in the intensive care unit? Crit Care Med. 2009;37:49–60.PubMedCrossRefGoogle Scholar
  5. 5.
    Dunn W, editor. Simulators in critical care and beyond. Des Plaines: Society of Critical Care Medicine; 2004.Google Scholar
  6. 6.
    Davis D, Thomson MA, Oxman A, Andrew D, Haynes RB. Changing physician performance: a systematic review of the effect of continuing medical education strategies. JAMA. 1995;274: 700–5.PubMedCrossRefGoogle Scholar
  7. 7.
    Davis D, Thomson O’Brien MA, Freemantle N, et al. Impact of formal continuing medical education. Do conferences, workshops, rounds, and other traditional continuing education activities change physician behavior or health care outcomes? JAMA. 1999;282:867–74.PubMedCrossRefGoogle Scholar
  8. 8.
    Colliver JA. Effectiveness of problem-based learning curricula: research and theory. Acad Med. 2000;75:259–66.PubMedCrossRefGoogle Scholar
  9. 9.
    Colliver JA. Educational theory and medical education practice: a cautionary note for medical school faculty. Acad Med. 2002;77:1217–20.PubMedCrossRefGoogle Scholar
  10. 10.
    Ozuah P, Curtis J, Stein R. Impact of problem based learning on residents’ self-directed learning. Arch Pediatr Adolesc Med. 2001;155:669–72.PubMedCrossRefGoogle Scholar
  11. 11.
    David TJ, Patel L. Adult learning theory, problem based learning, and paediatrics. Arch Dis Child. 1995;73:357–63.PubMedCentralPubMedCrossRefGoogle Scholar
  12. 12.
    Pediatrics: cardiac diseases and critical care medicine articles. Last accessed 28 Jan 2012.
  13. 13.
    Resident ICU course. Last accessed 26 Jan 2012.
  14. 14.
    Tegtmeyer K, Ibsen L, Goldstein B. Computer-assisted learning in critical care: from ENIAC to HAL. Crit Care Med. 2001;29:N177–82.PubMedCrossRefGoogle Scholar
  15. 15.
    Vozenilek J, Huff S, Reznek M, Gordon J. See one, do one, teach one: advanced technology in medical education. Acad Emerg Med. 2004;11:1149–54.PubMedCrossRefGoogle Scholar
  16. 16.
    Parmalee D, Michaelsen LK. Team-based learning: it’s here and it WORKS! (letter). Acad Med. 2010;85:1658.CrossRefGoogle Scholar
  17. 17.
    Shellenberger S, Seale JP, Harris DL, et al. Applying team-based learning in primary care residency programs to increase patient alcohol screening and brief interventions. Acad Med. 2009;84:340–6.PubMedCrossRefGoogle Scholar
  18. 18.
    Tegtmeyer K. Education in the age of the 80-hour work week. In: Tegtmeyer K, editor. Current concepts in pediatric critical care. Des Plaines: Society of Critical Care Medicine; 2005. p. 135–42.Google Scholar
  19. 19.
    American Academy of Pediatrics, Committee on Community Health Services. Community pediatrics: an annotated bibliography. Grove Village: American Academy of Pediatrics; 2002.Google Scholar
  20. 20.
    Cleveland W, Brownlee R. American Board of Pediatrics, future training of pediatricians: summary report of a series of conferences sponsored by the American Board of Pediatrics. Pediatrics. 1987;80:451–7.PubMedGoogle Scholar
  21. 21.
    Leslie L, Rappo P, Abelson H, Jenkins R, Sewall S. Final report of the FOPE II pediatric generalist of the future workgroup. Pediatrics. 2000;106:1199–223.PubMedGoogle Scholar
  22. 22.
    ACGME: common program requirements (effective July 1, 2010). Last accessed 28 Jan2012.
  23. 23.
    Vats A, Goin KH, Fortenberry JD. Lean analysis of a pediatric intensive care unit physician group rounding process to identify inefficiencies and opportunities for improvement. Pediatr Crit Care Med. 2011;12:415–21.PubMedCrossRefGoogle Scholar
  24. 24.
    Nishisaki A, Donoghue AJ, Colborn S, et al. Effect of just-in-time simulation training on tracheal intubation procedure safety in the pediatric intensive care unit. Anesthesiology. 2010;113:214–23.PubMedCrossRefGoogle Scholar
  25. 25.
    Weinstock PH, Kappus LJ, Garden A, Burns JP. Simulation at the point of care, reduced cost, in situ training via a mobile cart. Pediatr Crit Care Med. 2009;10:176–82.PubMedCrossRefGoogle Scholar
  26. 26.
    Wayne BD, Butter J, Siddall VJ, et al. Mastery learning of advanced cardiac life support skills by internal medicine residents using simulation technology and deliberate practice. J Gen Intern Med. 2006;21:251–6.PubMedCentralPubMedCrossRefGoogle Scholar
  27. 27.
    Barsuk JH, McGaghie WC, Cohen ER, O’Leary KJ, Wayne DB. Simulation-based mastery learning reduces complications during central venous catheter insertion in a medical intensive care unit. Crit Care Med. 2009;37:2697–701.PubMedCrossRefGoogle Scholar
  28. 28.
    Nishisaki A, Nguyen J, Colborn S, et al. Evaluation of multidisciplinary simulation training on clinical performance and team behavior during tracheal intubation procedures in a pediatric intensive care unit. Pediatr Crit Care Med. 2011;12:406–14.PubMedCrossRefGoogle Scholar
  29. 29.
    Frengley RW, Weller J, Torrie J, et al. The effect of a simulation-based training intervention on the performance of established critical care unit teams. Crit Care Med. 2011;12:1–7.CrossRefGoogle Scholar
  30. 30.
    Ventre KM, Collingridge DS, DeCarlo D, Schwild HA. Performance of a consensus scoring algorithm for assessing pediatric advanced life support competency using a computer screen-based simulator. Pediatr Crit Care Med. 2009;10:623–35.PubMedCrossRefGoogle Scholar
  31. 31.
    Carraccio C, Berman M. Intensive care: impact on resident education. Clin Pediatr. 1994;33:625–7.Google Scholar
  32. 32.
    Pediatric general competencies. Last accessed 28 Jan 2012.
  33. 33.
    Endacott R, Scholes J, Freeman M, Cooper S. The reality of clinical learning in critical care settings: a practitioner: student gap? J Clin Nurs. 2003;12:778–85.PubMedCrossRefGoogle Scholar
  34. 34.
    Dobbin K. Applying learning theories to develop teaching strategies for the critical care nurse. Don’t limit yourself to the formal classroom lecture. Crit Care Nurs Clin North Am. 2001;13:1–11.PubMedGoogle Scholar
  35. 35.
    Prioux DM, Bourcier BJ. Graduate nurses in the intensive care unit. Crit Care Nurse. 2008;28:44–52.Google Scholar
  36. 36.
    Chunta KS, Katrancha ED. Using problem-based learning in staff development: strategies for teaching registered nurses and new graduate nurses. J Contin Educ Nurs. 2010;41:557–64.PubMedGoogle Scholar
  37. 37.
    Dix G, Hughes SJ. Strategies to help students learn effectively. Nurs Stand. 2004;18:39–42.PubMedCrossRefGoogle Scholar
  38. 38.
    Hewitt-Taylor J, Gould D. Learning preferences of paediatric intensive care nurses. J Adv Nurs. 2002;38:288–95.PubMedCrossRefGoogle Scholar
  39. 39.
    Janvrin S. Introducing new graduates into pediatric intensive care. A thorough on-the-job program turns anxious graduates into confident beginning practitioners. Nurs Manag 1990;21:967.Google Scholar
  40. 40.
    Race TK, Skees J. Changing tides: improving outcomes through mentorship on all levels of nursing. Crit Care Nurs Q. 2010;33:163–74.PubMedCrossRefGoogle Scholar
  41. 41.
    Cato DL, Murray M. Use of simulation training in the intensive care unit. Crit Care Nurs Q. 2010;33:44–51.PubMedCrossRefGoogle Scholar
  42. 42.
    Bove L. Computer-assisted education for critical care nurses. Crit Care Nurs Clin North Am. 2001;13:73–81.PubMedGoogle Scholar
  43. 43.
    DeAmicis P. Interactive videodisc instruction is an alternative method for learning and performing a critical nursing skill. Comput Nurs. 1997;15:155–8.PubMedGoogle Scholar
  44. 44.
    Kinney MR. Education for critical care nursing. Annu Rev Nurs Res. 1990;8:161–76.PubMedGoogle Scholar
  45. 45.
    Kuiper R, Pesut D. Promoting cognitive and metacognitive reflective reasoning skills in nursing practice: self-regulated learning theory. J Adv Nurs. 2004;45:381–91.PubMedCrossRefGoogle Scholar
  46. 46.
    Dickerson P. 10 tips to help learning. J Nurses Staff Dev. 2003;19:240–6.CrossRefGoogle Scholar
  47. 47.
    Hohler S. Creating an environment conductive to adult learning. AORN J. 2003;77:833–5.PubMedCrossRefGoogle Scholar
  48. 48.
    Campbell J, Bell-Scott W. Unique solutions in pediatric critical care. Pediatr Nurs. 2001;27:483–91.PubMedGoogle Scholar
  49. 49.
    Kolb DA. Experiential learning: experience as the source of learning and development. Englewood Cliff: Prentice Hall; 1984.Google Scholar
  50. 50.
    Friedrich MJ. Practice makes perfect: risk free medical training with patient simulators. JAMA. 2002;288:2808–12.PubMedGoogle Scholar
  51. 51.
    Fiedor M. Pediatric simulation: a valuable tool for pediatric medical education. Crit Care Med. 2004;32(Suppl):S72–4.PubMedCrossRefGoogle Scholar
  52. 52.
    Cheng A, Donoghue A, Gilfoyle E, Eppich W. Simulation-based crisis resource management training for pediatric critical care medicine: a review for instructors. Pediatr Crit Care Med. 2012;13:197–203.Google Scholar
  53. 53.
    Halamek L, Kaegi DM, Gaba DM, et al. Time for a new paradigm in pediatric medical education: teaching neonatal resuscitation in a simulated delivery room environment. Pediatrics. 2000;106:e45.PubMedCrossRefGoogle Scholar
  54. 54.
    Boulet JR, Murray D, Kras J, et al. Reliability and validity of a simulation-based acute care skills assessment for medical students and residents. Anesthesiology. 2003;99:1270–80.PubMedCrossRefGoogle Scholar
  55. 55.
    Tekian A, McGuire CH, McGaghie WC. Innovative simulations for assessing professional competence: from paper and pencil to virtual reality. Chicago: University of Illinois at Chicago, Department of Medical Education; 1999.Google Scholar
  56. 56.
    Hugh DJ, Kurrek MM, Cohen MM, Cleave-Hogg D. The validity of performance assessments using simulation. Anesthesiology. 2001;95:36–42.CrossRefGoogle Scholar
  57. 57.
    Yager PH, Lok J, Klig JE. Advances in simulation for pediatric critical care and emergency medicine. Curr Opin Pediatr. 2011;23:293–7.PubMedCrossRefGoogle Scholar
  58. 58.
    Andreatta P, Saxton E, Thompson M, Annich G. Simulation-based mock codes significantly correlate with improved pediatric patient cardiopulmonary arrest survival rates. Pediatr Crit Care Med. 2011;12:33–8.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  • Girish G. Deshpande
    • 1
  • Gwen J. Lombard
    • 2
  • Adalberto TorresJr.
    • 3
  1. 1.Department of PediatricsChildren’s Hospital of IllinoisPeoriaUSA
  2. 2.Department of NeurosurgeryUniversity of FloridaGainesvilleUSA
  3. 3.Department of PediatricsNemours Children’s HospitalOrlandoUSA

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