International Journal of Academic Medicine

LETTER TO EDITOR
Year
: 2021  |  Volume : 7  |  Issue : 2  |  Page : 132--133

Clinical decision support and tele-mentorship as interventions for dissatisfaction and disengagement in intensive care unit training: The case of Libya


Mohamed Ben-Omran 
 Department of Anesthesiology and Perioperative Medicine, Augusta University, Augusta, GA 30912, USA

Correspondence Address:
Dr. Mohamed Ben-Omran
Department of Anesthesiology and Perioperative Medicine, Augusta University, 1120 15th Street, BI-2144, Augusta, GA 30912
USA




How to cite this article:
Ben-Omran M. Clinical decision support and tele-mentorship as interventions for dissatisfaction and disengagement in intensive care unit training: The case of Libya.Int J Acad Med 2021;7:132-133


How to cite this URL:
Ben-Omran M. Clinical decision support and tele-mentorship as interventions for dissatisfaction and disengagement in intensive care unit training: The case of Libya. Int J Acad Med [serial online] 2021 [cited 2021 Sep 26 ];7:132-133
Available from: https://www.ijam-web.org/text.asp?2021/7/2/132/319801


Full Text



To the Editor,

Although the history of medical education in Libya exceeds 50 years and multiple efforts have been made to modernize the health system, the quality of postgraduate medical education has deteriorated over the last decade and has failed to fulfill the standards and requirements of the World Federation of Medical Education.[1],[2],[3] This declining in the quality of education has been aggravated by the COVID-19 pandemic and partly by the lack of trust in teaching and assessment.[4] This is reflected in the dissatisfaction and disengagement among the trainees in intensive care units (ICUs). In this article, I describe my experiences in providing clinical decision support (CDS) and tele-mentorship to anesthesiology trainees in the ICU of Benghazi Medical Center (BMC), Libya.

CDS and tele-mentorship are potential interventions to address dissatisfaction during ICU training and to facilitate better engagement among the ICU trainees in Libya through the pandemic. A needs analysis involving five anesthesiology residents at BMC explained that clinical education in ICUs has been compromised because of insufficient teaching and clinical supervision from the faculty, inability to develop necessary clinical competencies, and the fear of making serious mistakes, which they noted were the most stressful aspects of their training in the ICU.

Four colleagues (intensivists from anesthesiology and pulmonology backgrounds at five academic institutes in the USA), the chair of the department of anesthesiology of BMC, and I informally discussed and determined realistic goals and a plan for an intensive curriculum for ICU trainees in Libya. We developed learning objectives with a focus on cognitive, affective, and teamwork competencies. The proposed method comprises daily virtual educational ICU rounds and case discussions (without patient-identifying information) over a month through encrypted WhatsApp calls. Thirty educational rounds were conducted from May 1 to 30, 2020, in the surgical ICU at BMC. Twelve ICU-anesthesiology residents participated, with an average of four residents in each session. Each resident attended ten rounds. An average of four cases were discussed and managed daily within 3 h. The main topics included sepsis and septic shock, traumatic brain and spinal cord injuries, trauma to major vessels, thoracic injury, acute respiratory lung syndrome, ICU delirium, anaphylactic shock, hemodynamics monitoring, daily goals, and handoff report implementation.

The main challenges we encountered in conducting the rounds were the time difference between the USA and Libya, the lack of essential diagnostic labs and critical equipment, and weak collaboration with other clinical departments. On conclusion of this experience, the residents strongly recommended the continuation of such interactions as part of future training initiatives and the extension of this experience to other hospitals in Libya.

Tele-mentorship of trainees in developing countries through CDS and virtual medical education offers great opportunities for global health initiatives. Our experience may serve as a model for the broader implementation of tele-mentorship and CDS in facilitating engagement and addressing dissatisfaction with postgraduate medical training in under-resourced settings. This topic should be studied at a larger scale.

Acknowledgment

I would like to thank Editage (www.editage.com) for English language editing.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

Ethical conduct of research

The authors of this manuscript declare that this scientific work complies with reporting quality, formatting, and reproducibility guidelines set forth by the EQUATOR Network. The authors also attest that this clinical investigation was determined to not require Institutional Review Board/Ethics Committee review, and the corresponding protocol/approval number is not applicable.

References

1Nasef A, Al-Griw MA, El Taguri A. Improving quality of education in extreme adversities-The case of Libya. J Biol Med 2020;4:006-11.
2Jabeal I, ur Rashid H. The Libyan Health System: Study of Medical and Allied Health Education and Training Institutions. Ministry of Health, Health Information and Documentation Center; 2018. Available From: http://www.seha.ly/en/wp-content/uploads/2017/11/Study-of-Medical-and-Allied-Health-Institutes-of-Libya.pdf. [Last accessed on 2019 Feb 02].
3Ambarek MS. The need for Quality Management Systems in Libyan universities. Libyan J Med. 2010;5:10.3402/ljm.v5i0.5285. Published 2010 Aug 20. doi: 10.3402/ljm.v5i0.5285
4Al-Areibi A. Medical education in Libya: Challenges, hopes, and recommendations. Libyan Int Med Univ J 2019;4:3-9.