Medical College of Wisconsin APP Critical Care Fellowship - How We Learn
The APP Critical Care Fellowship Program focuses on hands-on, clinical experiences across all six ICUs in addition to key acute care specialties as the foundation for critical care practice. In addition to clinical rotations providing patient experiences across each specialty ICU, the core critical care curriculum provides continuity and skill development focusing on 15 aspects of essential critical care skills throughout the 12-month program.
Didactic Education
The program integrates additional multi-faceted didactic opportunities to enhance the clinical learning experience including:
- In-person lectures
- Skills lab
- Case presentations
- Online didactics and learning modules
- Dedicated self-reflection
- Peer-led curriculum
- Scenario-based learning
- Specialty focused didactics including lectures, M&M, and journal clubs
Core Critical Care Curriculum
- Hemodynamics
- Respiratory failure
- Sedation and analgesia
- Altered mentation and delirium
- Renal failure
- Metabolic and electrolyte abnormalities
- Glycemic management during critical illness
- Acid/base disorders
- Sepsis and infections
- Hemorrhage and coagulopathy
- End-of-life
- Assessment and management of critically-ill patients
- Critical care nutrition
- Critical care quality
- APP critical care practice and team-based care
- Society of Critical Care Medicine Fundamental Critical Care Support Course
- BCLS
- ACLS
- ATLS (as available)
Procedural and Skills opportunity
- Skills labs
- Suturing
- Central Line Insertion
- Lumbar puncture
- Mechanical Ventilation Management
- Basic and Advanced EKG
- Ultrasound
- Online didactic
- Clinical experience
- Hands on clinical experience in all rotations in addition to the procedural rotation
Critical Care Rotations
Case Presentations
- All critical care fellows present at least 3 case presentations and lead an academic discussion to enhance learning and professional development within the fellowship team.
- Topics include diverse clinical patient experiences drawn from all rotations including acute biliary pancreatitis, DRESS, end-of-life management, molar pregnancies, clinical assessment of fluid balance, rejection after liver transplant, infective endocarditis, right ventricular failure, mucormycosis, graft versus host disease and many more.
Highlighted Fellowship Projects
Critical Care Bronchoscopy
Nicholas Caruso-Schaefer, PA-C
Interpretation of Diagnostic Imaging: An educational curriculum to better assist new Advanced Practice Providers (APP) in the diagnosis of life-threatening emergencies
Sarah Power, APNP and Liz Amato, PA-C
Implementing an Airway Management Curriculum in the APP Critical Care Fellowship
Averee Zent APNP and Jay Hume PA-C
Integration of Self-reflective Journaling into the APP Fellowship Program
Elizabeth Siegel, PA-C
Facilitating APP Fellowship Rotation Hand-offs
Sarah Tybring, MSN, AGACNP-BC, APNP
Optimization of Critical Care Patient and Family Communication
Justine Emerson, PA-C & Elise Rippelmeyer, MSN, ACACNP-BC, APNP
- Pilot of MD/APP Team Patient Cards in the TICU
- APP Critical Care Fellowship Patient & Family Communication Curriculum Development
Family Experience in the ICU – Qualitative assessment of family survey responses
Laura Mark, MPAS, PA-C, MPH
Development of an APP Preceptor/Learner Training Program for APP Fellowships
Joy Ikeri, DNP, AGACNP-BC, APNP
Optimization of the External APP Fellowship Website – Driving Change from the Viewpoint of the Applicant
Ravi Dholakia, PA-C
Critical Care Resource and Topic Guide for New Fellows
Sarah Wasz, PA-C and Brittany Lyda, PA-C
Point of Care Ultrasound in the ICU: Didactic and Hands on Curriculum for the APP Critical Care Fellow
Madison Leahy, PA-C and Paula Winiarski, APNP
Operationalizing CBME at MCW
Daniel Handler, APNP
Growing Evidence Based Medicine Skills
Lane Ringer, PA-C
Identifying Peer Engagement and Social Connection Needs for APPs in MCW APP Fellowship Programs
Alison Moody, APNP and Elena Lages, APNP
Growing Evidence Based Medicine Skills Continued: Journal Club in Action
Harry Gray, PA-C and Meaghan Reed, PA-C
Conflicted on Conflict: Recognition, Prevention and Management of Conflict between Clinicians and Surrogate Decision-Makers
Yekaterina Bezpalaya, APNP
Day in the life of an APP Critical Care Fellow
- Each day, APP fellows are assigned an APP preceptor to work with and are integrated into the academic, multi-professional critical care team.
- Daily education varies from bedside teaching, academic rounds, and rotation lectures to fellowship skills labs, journal clubs, and online didactics.
0630: Arrive in the ICU team room and confirm your patient assignment for the day
0645: Get sign-out from the overnight team
0700-0800: Pre-round
- Review data, assess your patients, and discuss any updates with the bedside nurse
- Prepare for rounds and formulate a plan of care for the day.
- Participate in academic patient care teaching
- Present your patients to the multidisciplinary team
- Collaborate with the critical care team to facilitate workflows and patient management
1100-1900: Critical Care Management
- Continue to assess and manage critically-ill patients
- Complete procedures
- Write critical care notes
- Service specific lectures, chalk talks, simulations, or other education
- Transfer, discharge, and admit patients
1900-1930: Hand-off to the night ICU team