Awareness and Understanding of Post-intensive Care Syndrome (PICS) Among Internal Medicine Residents in a Community Hospital Setting.
Source: PubMed, NCBI / U.S. National Library of Medicine
Background Post-intensive care syndrome (PICS) includes cognitive, psychological, and physical impairments that may persist after critical illness. Prior studies have shown that more than half of ICU survivors develop new physical, mental, or cognitive problems after discharge, underscoring the substantial burden of post-ICU morbidity. Despite this, awareness among healthcare providers remains limited. Internal medicine residents frequently care for ICU survivors during hospitalization and after discharge, and limited awareness may delay recognition of post-ICU complications and contribute to gaps in continuity of care. Objective To assess awareness of PICS, knowledge of its clinical domains and management concepts, and self-reported confidence in managing post-ICU sequelae among internal medicine residents in a community hospital and identify educational gaps. Methods We conducted a cross-sectional electronic survey of internal medicine residents at a community-based residency program from June to July 2023. The questionnaire assessed knowledge of PICS, familiarity with the Assess, prevent, and manage pain; Both spontaneous awakening trials and spontaneous breathing trials; Choice of analgesia and sedation; Delirium: assess, prevent, and manage; Early mobility and exercise; Family engagement and empowerment (ABCDEF) bundle, prior PICS education, and confidence in managing post-ICU sequelae. Descriptive statistics were used to summarize responses. Exploratory associations bet
Abstract
Background Post-intensive care syndrome (PICS) includes cognitive, psychological, and physical impairments that may persist after critical illness. Prior studies have shown that more than half of ICU survivors develop new physical, mental, or cognitive problems after discharge, underscoring the substantial burden of post-ICU morbidity. Despite this, awareness among healthcare providers remains limited. Internal medicine residents frequently care for ICU survivors during hospitalization and after discharge, and limited awareness may delay recognition of post-ICU complications and contribute to gaps in continuity of care. Objective To assess awareness of PICS, knowledge of its clinical domains and management concepts, and self-reported confidence in managing post-ICU sequelae among internal medicine residents in a community hospital and identify educational gaps. Methods We conducted a cross-sectional electronic survey of internal medicine residents at a community-based residency program from June to July 2023. The questionnaire assessed knowledge of PICS, familiarity with the Assess, prevent, and manage pain; Both spontaneous awakening trials and spontaneous breathing trials; Choice of analgesia and sedation; Delirium: assess, prevent, and manage; Early mobility and exercise; Family engagement and empowerment (ABCDEF) bundle, prior PICS education, and confidence in managing post-ICU sequelae. Descriptive statistics were used to summarize responses. Exploratory associations between prior PICS education and selected outcomes were assessed using Fisher's exact test, with odds ratios, 95% confidence intervals, and two-sided P values reported. Results Sixty-five of 75 residents responded (86.7%). Residents demonstrated substantial knowledge gaps regarding PICS, particularly in identifying affected populations, diagnostic tools, and familiarity with the ABCDEF bundle. Prior PICS education was significantly associated with greater familiarity with the ABCDEF bundle (OR, 11.47; 95% CI, 1.03-601.36; P = .023) and higher confidence in managing post-ICU sequelae (OR, 6.71; 95% CI, 1.71-33.17; P = .004), but not with other knowledge measures. These exploratory associations should be interpreted with caution, as the wide confidence intervals suggest limited precision and possible instability of some estimates. Conclusions Internal medicine residents demonstrated substantial knowledge gaps regarding PICS. Targeted educational strategies during residency may strengthen recognition and management of post-ICU complications.