Competencies Required by Anesthesiologists Managing Critically Ill Medical and Surgical Patients in an Intensive Care Unit

BACKGROUND:

CCM has emerged as an independent specialty over the last few decades. Anesthesiologists being perioperative physicians are an integral part of this progress, with many of them opting for CCM as a full-time career. The coronavirus disease 2019 (COVID-19) pandemic has brought unprecedented challenges to the health care system. Anesthesiologists working in the operating room (OR) and those working in the ICU have been the frontline workers along with other Critical Care professionals in the management of critically ill patients with COVID-19. Though a few countries have recognized CCM as a separate specialty of medicine, in most countries, it is considered as a sub-specialty of broad specialties like Anesthesiology, Pulmonary Medicine or Internal Medicine. Some professional bodies have developed a formal curriculum for training in CCM. The Competency-Based Training programme in Intensive Care Medicine (CoBaTrICE) from the European Society of Intensive Care Medicine (ESICM) is a widely accepted formal structured training curriculum in CCM. Most curricula are designed only for high-income, well-resourced training and practice environments and do not account for additional skills and competencies that may be required to practice in resource variable settings, something the COVID-19 pandemic has demonstrated needs to be universal. The transition of Anesthesiologists working in OR or managing critically ill surgical/ polytrauma patients into working in ICU has largely been smooth. Nevertheless, experts have noted deficiencies in the Anesthesiology training in certain competencies required for the management of critically ill medical and surgical patients in the ICU. This is often compounded by considerable variation in the training curriculum of the Anesthesiologists based on the geographical region and type of institution. There is a need to identify these competencies so that Anesthesiologists who wish to practice full time or part-time Critical Care can acquire these competencies to improve their ability to manage critically ill patients in ICU in different World Health Organization defined healthcare facilities levels. This may also help provide guidance to educators worldwide regarding the competencies to be included in Anesthesiology training that may help Anesthesiologists work better with critically ill patients in ICU. These competencies have never been formally identified or published. The investigators plan to review the existing competencies for CCM in the Anesthesiology curriculum across the globe through a preliminary survey. Thereafter, the investigators plan to identify the additional competencies required through consensus among Experts, using a Delphi method. These additional competencies, classified as mandatory, desirable, and optional, may serve as a guide for Anesthesiologists to practice Critical Care in ICU in different levels of health care facilities worldwide.

OBJECTIVES

1. The investigators aim to review/identify the existing competencies for CCM in the Anesthesiology curriculum across the globe.
2. The investigators aim to generate expert consensus on the additional competencies (mandatory desirable and optional) required for Anesthesiologists to practice Critical Care in the ICU.
3. Provide guidance to educators worldwide regarding the competencies to be included in the Anesthesiology curriculum that may help Anesthesiologists work better with critically ill patients in ICU.

METHODOLOGY