Didactics

Three times a week, a one-hour tutorial is presented to the ICU junior residents, interns, and medical students. These provide introductory didactic coverage of the SICU core curriculum to supplement rounds and bedside teaching by the ICU faculty, pharmacists, and nutritionists. In the second half of the year, the ACCM fellows take over many of the lectures themselves and so have the opportunity to hone their didactic teaching skills. ACCM fellow teaching focuses on evidence- based review of landmark critical care trials.

Once a week a one-hour tutorial is presented to the ICU senior residents, physician assistants, and acute care nurse practitioners on more advanced ICU topics, especially those related to postoperative cardiac care.

Dr. Jack Shanewise gives a weekly lecture on TEE to the combined group of ACCM and ACTA (Adult Cardiothoracic Anesthesiology) Fellows. This is a unique opportunity to receive what is essentially a one-year course on TEE delivered by an acknowledged expert.

Dr. May Hua leads a "flipped classroom," where fellows are provided with journal articles in advance, and are expected to critically appraise the studies prior to Journal Club. There is special emphasis on how to analyze study objectives, design, statistical analysis, results, and discussion.

These are interactive multidisciplinary critical care lectures for our own ACCM fellows together. Lectures are given by ICU faculty and non-ICU faculty (surgeons, pulmonologists, cardiologists, ID specialists, nephrologists, etc.), and visiting professors. These sessions are required to be interactive. Slides are limited to encourage student-directed learning.

ACCM fellows attend our weekly departmental Grand Rounds and have the opportunity to present cases 2-3 times per year.

Critical Care Grand Rounds is a monthly conference open to all staff at CUMC; the common denominator is an interest in critical care medicine. The audience includes faculty and house staff, nursing staff, therapists, pharmacists, and medical students. Columbia University faculty and visiting professors who are experts in critical care and related fields present lectures.

This is a multidisciplinary QI meeting attended by the cardiac surgeons, ICU faculty and fellows, ACTA faculty, nursing, and many ancillary services. QI indicators are reviewed, and our ACCM fellows summarize goals for the long stay (i.e., greater than 1 week) cardiac surgical patients in CTICU. There is an M&M discussion of all CTICU mortalities and re-admissions.

In addition, based upon their service rotation, fellows may attend a case review meeting with the liver transplant team every Friday morning, a monthly M&M meeting with the lung transplant team, and a weekly case review meeting with the VAD team.

This monthly multidisciplinary QI meeting is led by Dr.Vivek Moitra and addresses issues common to both ICUs. Members include ICU faculty and fellows, and senior leadership of nursing, pharmacy, physical therapy, nutrition, palliative care, respiratory therapy, physician assistants, and nurse practitioners in SICU and CTICU. It is the most important venue for formulating and updating ICU policies, procedures, and guidelines for our two units.

Our fellows are encouraged to attend major critical care meetings such as the Society of Critical Care Anesthesiologists (SOCCA) or the Society of Critical Care Medicine (SCCM). The Department of Anesthesiology provides $1,600 each year toward academic support and activities for each fellow.