APP Critical Care Fellowship - How We Learn
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.
- 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
- 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
- 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
- ATLS (as available)
Procedural and Skills opportunity
- Skills labs
- Central Line Insertion
- Lumbar puncture
- Mechanical Ventilation Management
- Basic and Advanced EKG
- Online didactic
- Clinical experience
- Hands on clinical experience in all rotations in addition to the procedural rotation
Critical Care Rotations
- Experience in-depth education and clinical experience with clinical dieticians in the critical care environment enhancing knowledge of critical care nutrition and promoting team-based patient care.
- A 1-week rotation on the multi-professional Diabetes Management Team providing APP fellows an immersed experience learning best practices for ICU glycemic control across critically-ill patient populations.
- A 1-week rotation on the multi-professional internal medicine team providing APP fellows with the opportunity to perform frequent procedures in the inpatient and ICU patient populations.
- 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.
- 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
- 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
- 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