Original Article

Resident Perceptions of Competency and Comfort Before and After Telemedicine-ICU Implementation

Authors: Alexa Summe, DO, Laura Foor, DO, Lauren Hoeck, FSA, Kristen Campbell, JD, Mark Boyd, MD, Mary Ann Barnes, MD

Abstract

Objectives: The purpose of this study was to examine the impact telemedicine in the intensive care unit (ICU) has on the competency, satisfaction, and education of resident physicians.

Methods: Telemedicine in the ICU was implemented in 2014 at a community hospital with 24 family medicine residents. Comfort with the performance of various common procedures; management of major medical diseases in the ICU; and level of comfort, attitudes, and satisfaction in work relationships with various staff members in the ICU were assessed before and 1 year after the telemedicine implementation. This was done by the residents’ respective training year and by all year groups combined. The Likert scores for each category were averaged by year group and by the three year groups combined, and these averages were compared pre- and posttelemedicine implementation using the t test method.

Results: All of the residents in the program participated voluntarily in the study, a 100% response rate. The results showed significant positive effects on resident education and satisfaction among ICU nurses and residents after the implementation of telemedicine-ICU. There were negative effects on residents’ learning opportunities with the family medicine attending physicians, feelings of being a valued team member, and comfort with ventilator management.

Conclusions: Telemedicine-ICU implementation had mixed effects on residents’ perceptions of their ICU experience and training. Further studies should be conducted to assess how to maximize resident training in this setting.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Sadaka F, Palagiri A, Trottier S, et al. Telemedicine intervention improves ICU outcomes. Crit Care Res Pract 2013;2013:456389.
 
2. Lilly CM, Cody S, Zhao H, et al. Hospital mortality, length of stay, and preventable complications among critically ill patients before and after tele-ICU reengineering of critical care processes. JAMA 2011;305: 2175-2183.
 
3. Thomas EJ, Lucke JF, Wueste L, et al. Association of telemedicine for remote monitoring of intensive care patients with mortality, complications, and length of stay. JAMA 2009;302:2671-2678.
 
4. Young LB, Chan PS, Lu X, et al. Impact of telemedicine intensive care unit coverage on patient outcomes: a systematic review and meta-analysis. Arch Intern Med 2011;171:498-506.
 
5. Coletti C, Elliott DJ, Zubrow MT. Resident perceptions of a tele-intensive care unit implementation. Telemed J E Health 2010;16:894-897.