APP Critical Care Fellowship - How We Learn
The APP Critical Care Fellowship Program focuses on hands-on, clinical experiences across all five 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. In addition to clinical education, the fellowship integrates the APP Fellowship Core Professional Curriculum in collaboration with all programs.
The fellowship program structure integrates the APP Phased Onboarding program including behaviorally-based milestones, and is formatted on technology platforms for education delivery, scheduling, and evaluations.
The fellowship program structure integrates the APP Phased Onboarding program including behaviorally-based milestones, and is formatted on technology platforms for education delivery, scheduling, and evaluations.
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
- Self-reflective journaling
- 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
Certification Courses
- 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
Fellowship Onboarding - 3 weeks
Critical Care Anesthesia CCA - Cardiovascular ICU - 6 weeks
Critical Care Intensive - 4-6 weeks
Critical Care Medicine - 6 weeks
Critical Care Neurology - 6 weeks
Critical Care Surgery and Trauma - 6 weeks
Fellowship Elective - Variable weeks
Infectious Diseases - 3-4 weeks
Mini-rotations - 1 week each
Palliative Care - 3 weeks
Transplant Surgery - 6 weeks
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 have covered a variety of clinical patient experiences including acute biliary pancreatitis, DRESS, end-of-life, molar pregnancies, clinical assessment of fluid balance, rejection after liver transplant, infective endocarditis, and more.
Fellowship Projects
- 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
Day in the life of an APP Critical Care Fellow
ICU rotation (Times vary by rotation)
- 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.
0800-1100: Academic critical care team rounds
- 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
Contact Us
Amanda Steffens
APP Fellowship Recruitment
appfellowship@mcw.edu
Sarah Vanderlinden, MPAS, PA-C, DFAAPA
APP Fellowship Director and APP Critical Care Program Director
svanderl@mcw.edu