The impact of a multi-specialty team for high risk pulmonary embolism on resident and fellow education

Department

Internal Medicine

Document Type

Article

Publication Title

Vascular Medicine (London, England)

Abstract

The impact of the Pulmonary Embolism Response Team (PERT) model on trainee physician education and autonomy over the management of high risk pulmonary embolism (PE) is unknown. A resident and fellow questionnaire was administered 1 year after PERT implementation. A total of 122 physicians were surveyed, and 73 responded. Even after 12 months of interacting with the PERT consultative service, and having formal instruction in high risk PE management, 51% and 49% of respondents underestimated the true 3-month mortality for sub-massive and massive PE, respectively, and 44% were unaware of a common physical exam finding in patients with PE. Comparing before and after PERT implementation, physicians perceived enhanced confidence in identifying ( p< 0.001), and managing ( p=0.003) sub-massive/massive PE, enhanced confidence in treating patients appropriately with systemic thrombolysis ( p=0.04), and increased knowledge of indications for systemic thrombolysis and surgical embolectomy ( p=0.043 and p< 0.001, respectively). Respondents self-reported an increased fund of knowledge of high risk PE pathophysiology (77%), and the perception that a multi-disciplinary team improves the care of patients with high risk PE (89%). Seventy-one percent of respondents favored broad implementation of a PERT similar to an acute myocardial infarction team. Overall, trainee physicians at a large institution perceived an enhanced educational experience while managing PE following PERT implementation, believing the team concept is better for patient care.

First Page

372

Last Page

376

DOI

10.1177/1358863X18767753

Volume

23

Issue

4

Publication Date

8-1-2018

Medical Subject Headings

Adult; Attitude of Health Personnel; Curriculum; Education, Medical, Graduate (methods); Female; Health Knowledge, Attitudes, Practice; Humans; Interdisciplinary Communication; Internship and Residency; Male; Middle Aged; Patient Care Team; Professional Autonomy; Pulmonary Embolism (diagnosis, mortality, therapy); Risk Assessment; Risk Factors; Specialization; Surveys and Questionnaires; Young Adult

PubMed ID

29786477

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