I’m a new ICU Doc, get me out of here!
Published Date: 20th May 2020
Publication Authors: Cochrane A, Howarth O
Background
Junior doctors rotate between hospitals and departments on a frequent basis and need to be able to provide safe and effective care from the first day in their new rotation. Good, timely local induction helps with this, however junior doctors are still required to familiarise themselves with a large amount of information, in a new environment whilst working with a new team. Trainee feedback on our induction process is that it is adequate, but whilst it is felt to be comprehensive we were concerned that it had become impersonal and risked information overload. We wanted to improve knowledge retention and promote team building.
Escape Rooms are immersive adventure puzzle games that have increased in popularity over the past decade. Players solve puzzles to solve codes used to unlock a series of boxes within a fixed time frame to ‘escape’ the room. They have previously been used in secondary education1, nursing2 and medical student3 teaching. We designed a medical escape room based on a fictional patients admission to intensive care.
Methods
This low fidelity scenario runs inside an ICU side room on the second day of the junior doctors placement after formal induction on the first day. This clinical setting helps familiarise junior doctors with the bed space, paperwork and ICU geography and they work together to find clues, interpret clinical data, and calculate risks to safely guide the admission of a patient with type 1 respiratory failure to the intensive care unit. These clues help unlock a series of four boxes to move the scenario forward with a maximum of 1 hour to 'break out'.
The tasks and clues reinforce both factual information (scoring systems, drug doses, extensions and bleeps) and attitudes (MDT working, consultant support, human factors and fatigue)
After the session a short debrief is held to clarify issues with either the game itself or any points about induction or the unit which are unclear.
Results
Trainees found the session engaging, enjoyable and useful.
Conclusion
This novel approach to induction has been well received by our trainees, currently we have evaluated learners reaction and satisfaction, in future we would like to assess the higher levels of Kirkpatrick’s evaluation model by accessing knowledge retention and behavioural change.
Cochrane, A; Bolton, N; Howarth, O. (2020). I’m a new ICU Doc, get me out of here! The use of an interactive Escape Room format to facilitate junior doctor induction. Journal of the Intensive Care Society. 21 (2), 30-31