Future of ICU Education

OVERVIEW

While the future is unpredictable, it is important to anticipate and prepare for possibilities.

We can try to do this by:

  • looking at “hard trends” (measurable facts about transformation in different fields)
  • understanding the present (often “the future is already here, it just isn’t evenly distributed yet” – William Gibson)

VIDEO SLIDECAST

HARD TRENDS IN EDUCATION

Simpson et al (2018) identified the following hard trends affecting medical education, which I think can be applied more widely to the interprofessional ICU setting.

  • Outsourcing of education – pre-pared resources and learning packages whether they be from Colleges, international bodies, other hospitals, online ebooks, or FOAM resources
  • Learning analytics/ Big Data
  • Technology – extended reality (AR/VR/ mixed reality), LMS, video/ audio communication tools
  • Learner as consumer and co-designer – FOAM resources, education programmes publishing blogs, micro-credentials
  • Regulation and alignment – regulators and accreditors will likely emphasise integrating education and patient care outcomes, which will necessitate a focus on interprofessional team-based approaches

EMERGING ROLES FOR CLINICIAN EDUCATORS

Simpson et al (2018) identified emerging roles for educators:

  • Diagnostic assessor – use of multi-source data – including learning analytics – to identify and close performance gaps
  • Content curator – select, sequence, and deliver outsourced content
  • Technology adopter – fluent in selecting using technologies appropriately
  • Learner-centred navigator and professional coach – guides use of resources and how to learn to reach performance targets
  • Clinician role model – acts as an exemplar for future clinician roles, which will change over time
  • Learning environment designer, creator, and implementer – science-based approach to all aspects of teaching and programme development and delivery

“HARD TRENDS” IN ICU

  • Affordability crisis – need for greater efficiency to overcome healthcare inequities and increased future demand and cost; healthcare models will need to evolve…
  • Healthcare needs – ageing population with complex comorbidities; episodic external crises (e.g. pandemics); ongoing rise of patient safety (and intolerance of iatrogenic disease)
  • Workforce – many complex issues: stress, burnout, and wellbeing; ageing (imminent intensivist “retirement bomb”), professionalism (bullying, systemic biases), increasing diversity
  • Technology – important driver as ICU is one of the most technology-driven areas of healthcare (e.g. telemedicine; devices for monitoring and interventions, organ supports and transplants, electronic health records and decision support systems)
  • Adaptability – ICU need to be able to adapt to changing population health needs, and individuals need to be redeployable and continue learning to best serve their patients

POSSIBLE RESPONSES TO FUTURE ICU EDUCATION CHALLENGES

  • Funding – education and training historically neglected (Frenk et al, 2010); needs to be addressed as healthcare is entirely dependent on having well trained clinical staff
  • Healthcare and workforce models – anticipate new, more efficient models of cares. Physicians as team leaders with generalist skillset including decision-making and communication. However, specialist physicians are too expensive and take too long to train so expect expanded interprofessional teams with specialist technicians. Don’t need to be a doctor to be highly skilled! Most non-ED/ICU/HDU care will likely be community-based/ managed remotely.
  • Coordination of training pipeline – overarching vision to match number of trainees with number of jobs to meet society’s needs; integration of undergraduate and postgraduate training and continuing professional development.
  • Developing Clinician Educators – we are doing this with the ANZCEN Clinician Educator Incubator programme: crating an interprofessional community of practice prepared for emerging educator roles.
  • Supporting education research and scholarship – funding, trainee projects, dedicated journal sections on education and training.
  • Curriculum renewal, competency-based education, and programmatic assessment – curriculum needs to prepare staff for the future not the present; need to embed key topics into all facets of the curriculum (leadership, professionalism, interprofessionalism, wellbeing, telemedicine and digital health, safety science, systems engineering, etc); need for time-variable competency-based training and programmatic assessment.
  • Learning how to learn – a requirement for lifelong learning and creating adaptable, redeployable staff.

REFERENCES AND LINKS

  • Frenk J, Chen L, Bhutta ZA, et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. Lancet. 2010;376(9756):1923-1958. doi:10.1016/S0140-6736(10)61854-5 [pubmed]
  • Lucey CR, Davis JA, Green MM. We Have No Choice but to Transform: The Future of Medical Education After the COVID-19 Pandemic. Acad Med. 2022;97(3S):S71-S81. doi:10.1097/ACM.0000000000004526 [article]
  • Simpson D, Marcdante K, Souza KH, Anderson A, Holmboe E. Job Roles of the 2025 Medical Educator. J Grad Med Educ. 2018;10(3):243-246. doi:10.4300/JGME-D-18-00253.1 [article]

SMILE

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Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.

After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.

He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE.  He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.

His one great achievement is being the father of three amazing children.

On Twitter, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

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