C56-40 Expanding Rapid Response Training Amongst Internal Medicine Residents

Abstract Rationale Rapid response teams (RRTs) are a multidisciplinary group of medical professionals deployed to evaluate and treat deteriorating hospitalized patients. The use of RRTs has been shown to reduce cardiac arrests in hospitals. The desire for consistency among RRT members has led to exclusion of internal medicine (IM) trainees, creating a gap in education. We sought to evaluate the impact of a novel RRT curriculum at a single academic institution. Methods We developed a combined hospital medicine/RRT elective which included an asynchronous curriculum and resident integration into the RRT. Residents worked with a critical care attending to lead rapid responses and cardiac arrests. Residents who signed up for the elective were recruited to participate in our study, which included a pre-and post-rotation survey (demographic/clinical exposure measures, and confidence across 16 rapid response conditions on a Likert scale 1-5), a written 20 question knowledge assessment, and a standardized virtual simulation scored for overall performance and entrustment (1-4 scale). Controls were contemporaneous residents who did not participate in the elective. Due to our small numbers, we provide descriptive statistics. Results 19 residents participated in this study (9 intervention, 10 control). Despite similar baseline characteristics, including ICU exposure and inpatient rotations, baseline confidence in leading a RRT was higher in the control group compared to intervention (2.4 vs 1.1 out of 5). The intervention group’s overall confidence improved to 3.25 out of 5 after the rotation with a mean increase of + 0.87 on a 5-point scale (95% CI + 0.45 to + 1.29; p = 0.002, Figure 1A). Knowledge scores trended higher post-curriculum (mean increase +2.0; 95% CI -1.4 to + 5.4; p = 0.16) but were not significantly different compared with controls (14.9 vs 15.3; p = 0.71, Figure 1B). Entrustment scores did not differ between groups (3.0 vs 2.7; p = 0.62, Figure 1C). Simulation performance was numerically lower in the intervention group after excluding non-participating residents (35.6 vs 39.9; p = 0.36, Figure1D). After elective completion, 25% of participants had over confidence (confidence to entrustment score ratio 1.5) compared with 50% of the control group. Conclusions Implementation of a structured rapid response curriculum for IM residents improved participant confidence and knowledge. Participation in the elective was associated with improved self-assessment. More work is needed to optimize the role of IM residents in RRTs. This abstract is funded by: The Competitive Research Fund of UPMC Shadyside Hospital