Change In Resident Resuscitation-Specific Confidence and Anxiety Levels from a Novel Rotation

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Critical Care Medicine


Introduction/Hypothesis: Implemented as a pilot rotation in September 2015, the novel Resuscitation and Research Rotation (RRR) has bloomed into a required PGY-2 clerkship that focuses on bedside care for high acuity patients including sepsis, cardiac arrest, pulmonary embolism, and neurologic emergencies. The objective of this study is to survey and analyze pre and post RRR responses of PGY2 rotators in resus-specific measure of confidence and anxiety at a single center. Methods: Rotators were anonymously and voluntarily surveyed from December 2015 to December 2018 with a pre-post RRR survey. Likert-scale questions include three measuring situational confidence in life saving techniques (LST), leading a resuscitation (LAR), and knowing when to ask for help. Two questions measuring situational anxiety included performing an endotracheal intubation and recognizing different cardiac dysrhythmias. Measurements were scaled from 1-5 or 1-4, with higher levels representing higher levels of confidence or anxiety. Descriptive analyses were performed to summarize findings using frequencies and percentage. To account for the difference in pre-post survey response and the anonymity of the surveys, we tested if the pre-post outcomes independently achieve a clinically significant pre-specified value using exact binomial proportion tests. Results: A total of 36 and 25 rotators were included in pre- and post-surveys, respectively. Pre-post levels of high confidence were as follows; 47.2% and 76% for LST, 63.9% and 75% for LAR, and 83.3% and 97.1% for knowing when to ask for help. Both percentages of high confidence of LST and LAR in the post were significantly higher than 50% (p=0.01). The response of high confidence in the post of knowing when to ask for help was significantly higher than 75% (p=0.04). There was change in recognizing different dysrhythmias with pre-post lower anxiety of 77.8% and 95.8%; the response of lower anxiety in the post was significantly higher than 80% (p=.03). Moreover, there was 100% lower anxiety with endotracheal intubations in the pre and 96% lower anxiety in the post. Conclusions: The RRR pre-post surveys demonstrate that the PGY2 EM residents have significant improvement in their confidence in LST, LAR and knowing when to ask for help; and in their anxiety in recognizing different arrhythmias.





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