Skip to main content
Top
Published in: Intensive Care Medicine 12/2005

01-12-2005 | Special Article

The Acute Care Undergraduate TEaching (ACUTE) Initiative: consensus development of core competencies in acute care for undergraduates in the United Kingdom

Authors: Gavin D. Perkins, Hannah Barrett, Ian Bullock, David A. Gabbott, Jerry P. Nolan, Sarah Mitchell, Alasdair Short, Christopher M. Smith, Gary B. Smith, Susan Todd, Julian F. Bion

Published in: Intensive Care Medicine | Issue 12/2005

Login to get access

Abstract

Background

The care of the acutely ill patient in hospital is often sub-optimal. Poor recognition of critical illness combined with a lack of knowledge, failure to appreciate the clinical urgency of a situation, a lack of supervision, failure to seek advice and poor communication have been identified as contributory factors. At present the training of medical students in these important skills is fragmented. The aim of this study was to use consensus techniques to identify the core competencies in the care of acutely ill or arrested adult patients that medical students should possess at the point of graduation.

Design

Healthcare professionals were invited to contribute suggestions for competencies to a website as part of a modified Delphi survey. The competency proposals were grouped into themes and rated by a nominal group comprised of physicians, nurses and students from the UK. The nominal group rated the importance of each competency using a 5-point Likert scale.

Results

A total of 359 healthcare professionals contributed 2,629 competency suggestions during the Delphi survey. These were reduced to 88 representative themes covering: airway and oxygenation; breathing and ventilation; circulation; confusion and coma; drugs, therapeutics and protocols; clinical examination; monitoring and investigations; team-working, organisation and communication; patient and societal needs; trauma; equipment; pre-hospital care; infection and inflammation. The nominal group identified 71 essential and 16 optional competencies which students should possess at the point of graduation.

Conclusions

We propose these competencies form a core set for undergraduate training in resuscitation and acute care.
Appendix
Available only for authorised users
Literature
1.
2.
go back to reference Franklin C, Mathew J (1994) Developing strategies to prevent inhospital cardiac arrest: analyzing responses of physicians and nurses in the hours before the event. Crit Care Med 22:244–247PubMed Franklin C, Mathew J (1994) Developing strategies to prevent inhospital cardiac arrest: analyzing responses of physicians and nurses in the hours before the event. Crit Care Med 22:244–247PubMed
3.
go back to reference Hillman KM, Bristow PJ, Chey T, Daffurn K, Jacques T, Norman SL, Bishop GF, Simmons G (2002) Duration of life-threatening antecedents prior to intensive care admission. Intensive Care Med 28:1629–1634CrossRefPubMed Hillman KM, Bristow PJ, Chey T, Daffurn K, Jacques T, Norman SL, Bishop GF, Simmons G (2002) Duration of life-threatening antecedents prior to intensive care admission. Intensive Care Med 28:1629–1634CrossRefPubMed
4.
go back to reference McQuillan P, Pilkington S, Allan A, Taylor B, Short A, Morgan G, Nielsen M, Barrett D, Smith G, Collins CH (1998) Confidential inquiry into quality of care before admission to intensive care. BMJ 316:1853–1858PubMed McQuillan P, Pilkington S, Allan A, Taylor B, Short A, Morgan G, Nielsen M, Barrett D, Smith G, Collins CH (1998) Confidential inquiry into quality of care before admission to intensive care. BMJ 316:1853–1858PubMed
5.
go back to reference Neale G (1998) Risk management in the care of medical emergencies after referral to hospital. J R Coll Physicians (Lond) 32:125–129 Neale G (1998) Risk management in the care of medical emergencies after referral to hospital. J R Coll Physicians (Lond) 32:125–129
6.
go back to reference McGloin H, Adam SK, Singer M (1999) Unexpected deaths and referrals to intensive care of patients on general wards. Are some cases potentially avoidable? J R Coll Physicians (Lond) 33:255–259 McGloin H, Adam SK, Singer M (1999) Unexpected deaths and referrals to intensive care of patients on general wards. Are some cases potentially avoidable? J R Coll Physicians (Lond) 33:255–259
8.
go back to reference Vincent C, Neale G, Woloshynowych M (2001) Adverse events in British hospitals: preliminary retrospective record review. BMJ 322:517–519CrossRefPubMed Vincent C, Neale G, Woloshynowych M (2001) Adverse events in British hospitals: preliminary retrospective record review. BMJ 322:517–519CrossRefPubMed
9.
go back to reference Buist MD, Moore GE, Bernard SA, Waxman BP, Anderson JN, Nguyen TV (2002) Effects of a medical emergency team on reduction of incidence of and mortality from unexpected cardiac arrests in hospital: preliminary study. BMJ 324:387–390CrossRefPubMed Buist MD, Moore GE, Bernard SA, Waxman BP, Anderson JN, Nguyen TV (2002) Effects of a medical emergency team on reduction of incidence of and mortality from unexpected cardiac arrests in hospital: preliminary study. BMJ 324:387–390CrossRefPubMed
10.
go back to reference Bellomo R, Goldsmith D, Uchino S, Buckmaster J, Hart GK, Opdam H, Silvester W, Doolan L, Gutteridge G (2003) A prospective before-and-after trial of a medical emergency team. Med J Aust 179:283–287PubMed Bellomo R, Goldsmith D, Uchino S, Buckmaster J, Hart GK, Opdam H, Silvester W, Doolan L, Gutteridge G (2003) A prospective before-and-after trial of a medical emergency team. Med J Aust 179:283–287PubMed
11.
go back to reference Priestley G, Watson W, Rashidian A, Mozley C, Russell D, Wilson J, Cope J, Hart D, Kay D, Cowley K, Pateraki J (2004) Introducing Critical Care Outreach: a ward-randomised trial of phased introduction in a general hospital. Intensive Care Med 30:1398–1404CrossRefPubMed Priestley G, Watson W, Rashidian A, Mozley C, Russell D, Wilson J, Cope J, Hart D, Kay D, Cowley K, Pateraki J (2004) Introducing Critical Care Outreach: a ward-randomised trial of phased introduction in a general hospital. Intensive Care Med 30:1398–1404CrossRefPubMed
12.
go back to reference Parr M (2004) Critical care outreach: some answers, more questions. Intensive Care Med 30:1261–1262CrossRefPubMed Parr M (2004) Critical care outreach: some answers, more questions. Intensive Care Med 30:1261–1262CrossRefPubMed
13.
go back to reference Shen J, Joynt GM, Critchley LA, Tan IK, Lee A (2003) Survey of current status of intensive care teaching in English-speaking medical schools. Crit Care Med 31:293–298CrossRefPubMed Shen J, Joynt GM, Critchley LA, Tan IK, Lee A (2003) Survey of current status of intensive care teaching in English-speaking medical schools. Crit Care Med 31:293–298CrossRefPubMed
14.
go back to reference Phillips PS, Nolan JP (2001) Training in basic and advanced life support in UK medical schools: questionnaire survey. BMJ 323:22–23CrossRefPubMed Phillips PS, Nolan JP (2001) Training in basic and advanced life support in UK medical schools: questionnaire survey. BMJ 323:22–23CrossRefPubMed
15.
go back to reference Harrison GA, Hillman KM, Fulde GW, Jacques TC (1999) The need for undergraduate education in critical care. (Results of a questionnaire to year 6 medical undergraduates, University of New South Wales and recommendations on a curriculum in critical care). Anaesth Intensive Care 27:53–58PubMed Harrison GA, Hillman KM, Fulde GW, Jacques TC (1999) The need for undergraduate education in critical care. (Results of a questionnaire to year 6 medical undergraduates, University of New South Wales and recommendations on a curriculum in critical care). Anaesth Intensive Care 27:53–58PubMed
16.
go back to reference Soar J, Perkins GD, Harris S, Nolan J (2003) The immediate life support course. Resuscitation 57:21–26CrossRefPubMed Soar J, Perkins GD, Harris S, Nolan J (2003) The immediate life support course. Resuscitation 57:21–26CrossRefPubMed
17.
go back to reference Smith GB, Osgood VM, Crane S (2002) ALERT—a multiprofessional training course in the care of the acutely ill adult patient. Resuscitation 52:281–286CrossRefPubMed Smith GB, Osgood VM, Crane S (2002) ALERT—a multiprofessional training course in the care of the acutely ill adult patient. Resuscitation 52:281–286CrossRefPubMed
18.
go back to reference Perkins GD, Nolan J, Harris S, Mitchell S, Smith GB, Gabbott D, Short A, Bion JF (2004) The ACUTE initiative. Resuscitation 62:319CrossRef Perkins GD, Nolan J, Harris S, Mitchell S, Smith GB, Gabbott D, Short A, Bion JF (2004) The ACUTE initiative. Resuscitation 62:319CrossRef
19.
go back to reference Perkins GD, Bion JF (2004) The Acute Care Undergraduate TEaching Initiative (ACUTE). Crit Care Med 32:A65 Perkins GD, Bion JF (2004) The Acute Care Undergraduate TEaching Initiative (ACUTE). Crit Care Med 32:A65
20.
go back to reference Goldfrad C, Vella K, Bion JF, Rowan KM, Black NA (2000) Research priorities in critical care medicine in the UK. Intensive Care Med 26:1480–1488CrossRefPubMed Goldfrad C, Vella K, Bion JF, Rowan KM, Black NA (2000) Research priorities in critical care medicine in the UK. Intensive Care Med 26:1480–1488CrossRefPubMed
21.
go back to reference Ringsted C, Schroeder TV, Henriksen J, Ramsing B, Lyngdorf P, Jonsson V, Scherpbier A (2001) Medical students’ experience in practical skills is far from stakeholders’ expectations. Med Teach 23:412–416CrossRefPubMed Ringsted C, Schroeder TV, Henriksen J, Ramsing B, Lyngdorf P, Jonsson V, Scherpbier A (2001) Medical students’ experience in practical skills is far from stakeholders’ expectations. Med Teach 23:412–416CrossRefPubMed
22.
go back to reference Smith GB, Poplett N (2002) Knowledge of aspects of acute care in trainee doctors. Postgrad Med J 78:335–338CrossRefPubMed Smith GB, Poplett N (2002) Knowledge of aspects of acute care in trainee doctors. Postgrad Med J 78:335–338CrossRefPubMed
23.
go back to reference Shen J, Joynt GM, Critchley LA, Tan IK, Lee A (2003) Survey of current status of intensive care teaching in English-speaking medical schools. Crit Care Med 31:293–298CrossRefPubMed Shen J, Joynt GM, Critchley LA, Tan IK, Lee A (2003) Survey of current status of intensive care teaching in English-speaking medical schools. Crit Care Med 31:293–298CrossRefPubMed
24.
go back to reference Frankel HL, Rogers PL, Gandhi RR, Freid EB, Kirton OC, Murray MJ (2004) What is taught, what is tested: findings and competency-based recommendations of the Undergraduate Medical Education Committee of the Society of Critical Care Medicine. Crit Care Med 32:1949–1956CrossRefPubMed Frankel HL, Rogers PL, Gandhi RR, Freid EB, Kirton OC, Murray MJ (2004) What is taught, what is tested: findings and competency-based recommendations of the Undergraduate Medical Education Committee of the Society of Critical Care Medicine. Crit Care Med 32:1949–1956CrossRefPubMed
25.
go back to reference Barrett H, Bion JF (2005) An international survey of training in adult intensive care medicine. Intensive Care Med 31:553–561CrossRefPubMed Barrett H, Bion JF (2005) An international survey of training in adult intensive care medicine. Intensive Care Med 31:553–561CrossRefPubMed
26.
go back to reference Spady WG (1988) Organising for results: the basis of authentic restructuring and reform. Educ Leadersh 10:4–8 Spady WG (1988) Organising for results: the basis of authentic restructuring and reform. Educ Leadersh 10:4–8
27.
go back to reference Rees CE (2004) The problem with outcomes-based curricula in medical education: insights from educational theory. Med Educ 38:593–598CrossRefPubMed Rees CE (2004) The problem with outcomes-based curricula in medical education: insights from educational theory. Med Educ 38:593–598CrossRefPubMed
28.
go back to reference Moercke AM, Eika B (2002) What are the clinical skills levels of newly graduated physicians? Self-assessment study of an intended curriculum identified by a Delphi process. Med Educ 36:472–478CrossRefPubMed Moercke AM, Eika B (2002) What are the clinical skills levels of newly graduated physicians? Self-assessment study of an intended curriculum identified by a Delphi process. Med Educ 36:472–478CrossRefPubMed
29.
go back to reference Stewart J, O’Halloran C, Harrigan P, Spencer JA, Barton JR, Singleton SJ (1999) Identifying appropriate tasks for the preregistration year: modified Delphi technique. BMJ 319:224–229PubMed Stewart J, O’Halloran C, Harrigan P, Spencer JA, Barton JR, Singleton SJ (1999) Identifying appropriate tasks for the preregistration year: modified Delphi technique. BMJ 319:224–229PubMed
30.
go back to reference Jones J, Hunter D (1995) Consensus methods for medical and health services research. BMJ 311:376–380PubMed Jones J, Hunter D (1995) Consensus methods for medical and health services research. BMJ 311:376–380PubMed
Metadata
Title
The Acute Care Undergraduate TEaching (ACUTE) Initiative: consensus development of core competencies in acute care for undergraduates in the United Kingdom
Authors
Gavin D. Perkins
Hannah Barrett
Ian Bullock
David A. Gabbott
Jerry P. Nolan
Sarah Mitchell
Alasdair Short
Christopher M. Smith
Gary B. Smith
Susan Todd
Julian F. Bion
Publication date
01-12-2005
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 12/2005
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-005-2837-4

Other articles of this Issue 12/2005

Intensive Care Medicine 12/2005 Go to the issue

Announcements

December 2005