We seek to develop and implement an educational tool on neuromuscular respiratory failure for internal medicine trained critical care fellows. We aim to assess the tool’s success with pre- and post-test score comparisons.

A significant proportion of the United States does not have access to a dedicated neurological intensive care unit, and medical intensivists and pulmonologists are often expected to manage patients with primary neurological issues. While the Accreditation Council for Graduate Medical ºÃÉ«ÏÈÉú stipulates that critical care medicine curriculum should include neurologic disorders requiring intensive care, education is lacking for many trainees. We identified neuromuscular respiratory failure as a topic with a paucity of formal training for critical care medicine fellows. Program directors of pulmonary/critical care fellowships agreed that their didactic curricula could be improved. 

We developed a 23-minute video lecture on assessing and managing patients with neuromuscular respiratory failure. Topics include: demonstrations of high-yield physical exam maneuvers, clinical guidelines with specific attention to management differences between neuromuscular and non-neurologic mediated respiratory failure, and a brief overview of evaluating and managing patients with acute inflammatory demyelinating polyradiculoneuropathy (AIDP) and myasthenic crisis. A ten item pre-module assessment will be conducted, followed by presentation of the program during fellowship didactic time. A supplemental review guide will be provided. A post-module assessment will be conducted in four weeks. 

Five pulmonary/critical care fellowship programs at U.S. training institutions are currently participating in the program, with dates scheduled for implementation of the program. Data is being collected and will be presented in poster format. 

This educational tool is an easily distributable tool to address a training gap in critical care fellowship training. Our educational curriculum is designed for multidisciplinary use, and can be expanded to educate other physician groups, as well as advanced practice providers.