"A Lot to Offer": Nurses as Educators for Medical Residents in an Academic Medical Center Intensive Care Unit.

J Contin Educ Health Prof

Dr. Petri is a Faculty Member in the Division of Pulmonary, Critical Care, and Sleep Medicine, and the Shapiro Institute for Education and Research at Beth Israel Deaconess Medical Center and Instructor in Medicine at Harvard Medical School, Boston, MA. Ms. Beltran is Senior Research Coordinator at the New York University Grossman School of Medicine, New York, NY. Ms. Russell is the Nursing Director for the Medical Intensive Care Unit at Beth Israel Deaconess Medical Center, Boston, MA. Dr. FitzGerald is the Nursing Director for the Medical/Surgical Intensive Care Unit at Beth Israel Deaconess Medical Center, Boston, MA. Dr. Sullivan is Director of Education Research at the Shapiro Institute for Education and Research and Associate Professor of Medicine, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA. Dr. Anandaiah is Program Director of the Massachusetts General Hospital/Beth Israel Deaconess Medical Center/Harvard Pulmonary and Critical Care Medicine Fellowship, and Assistant Professor of Medicine, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA.

Published: July 2024

Introduction: The role of fully trained interprofessional clinicians in educating residents has not been rigorously explored. The intensive care unit (ICU), where multiprofessional teamwork is essential to patient care, represents an ideal training environment in which to study this role. This study aimed to describe the practices, perceptions, and attitudes of ICU nurses regarding teaching medical residents and to identify potential targets to facilitate nurse teaching.

Methods: Using a concurrent mixed-methods approach, we administered surveys and focus groups to ICU nurses from September to November 2019 at a single, urban, tertiary, academic medical center. Survey data were analyzed with descriptive and comparative statistics. Focus group data were analyzed using the Framework method of content analysis.

Results: Of nurses surveyed, 75 of 96 (78%) responded. Nurses generally held positive attitudes about teaching residents, describing it as both important (52%, 36/69) and enjoyable (64%, 44/69). Nurses reported confidence in both clinical knowledge base (80%, 55/69) and teaching skills (71%, 49/69), but identified time, uncertainty about teaching topics, and trainee receptiveness as potential barriers. Ten nurses participated in focus groups. Qualitative analysis revealed three major themes: nurse-specific factors that impact teaching, the teaching environment, and facilitators of teaching.

Discussion: ICU nurses carry positive attitudes about teaching residents, particularly when facilitated by the attending, but this enthusiasm can be attenuated by the learning environment, unknown learner needs, and trainee attitudes. Identified facilitators of nurse teaching, including resident presence at the bedside and structured opportunities for teaching, represent potential targets for interventions to promote interprofessional teaching.

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http://dx.doi.org/10.1097/CEH.0000000000000513DOI Listing

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