(105) Systems-Based Approach to ICU Patient Work-Up for Professional Students

Introduction: Faculty adopted a systems-based patient work-up in a Critical Care Pharmacy course to orient students to the bedside patient care delivery format in the intensive care unit (ICU). Problem-based presentations may be preferred for patients with a single acute issue; however, for complex ICU patients a systems-based work-up provides a framework for the presentation and helps to ensure nothing is missed. Systems evaluated included neurological, pulmonary, cardiovascular, GI/GU/endocrine, hematology/infectious diseases, and ending with pertinent laboratory findings, lines/drains/airways, and prophylaxis regimens. Using a flipped classroom model students viewed lectures on 5 separate disease topics and were given a patient case for each topic. They organized a system-based assessment and plan for the 5 patient cases.

Methods: To establish effectiveness of this teaching innovation, student academic performance in the 2024 course (systems-based work-up) was compared to the 2023 course (non-monitored work-up). Comparisons between individual readiness quizzes (IRATs), final exams, and final grades were performed using t-tests. In the 2024 course, an ANOVA test was performed to evaluate differences in each patient work-up to evaluate students’ skill progression.

Results: Twenty-five students were analyzed in the 2023 cohort and 21 students in the 2024 cohort. No significant differences in the performance on the IRATs were noted. Average performance was within the range of 4-5.0/5.0 on quizzes 1, 2, and 4, and 3.5-4.0/5.0 on quizzes 3 and 5. Final exam scores, final grades, and the distribution of grades were also similar between cohorts. In the ANOVA analysis of the 2024 cohort, performance on the final patient work-up improved significantly in comparison to the first patient work-up.

Conclusions: A systems-based approach to patient work-up oriented students to learning and caring for patients in the ICU environment without affecting academic performance. Evidence of skills progression was also observed. Further research is needed to establish the effect on experiential performance.