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Curriculum

All fellow educational activities (lectures, journal clubs, M&M conference, guideline reviews) occur from 10:00-11:00 AM on weekdays (Monday-Friday), unless otherwise noted.

Didactic Lecture Series

Fellows attend fellow-specific didactic lectures several times a week throughout the year. These lectures are presented by faculty from within the intensive care division as well as experts from other departments in the institution. The topics covered during this series provide a comprehensive knowledge of critical care medicine and are selected based on ACGME-published guidelines as well as fellow feedback.

Point of Care Ultrasound and Critical Care Echocardiography

Basic transthoracic cardiac and pulmonary ultrasonography is rapidly becoming a standard of care for intensivitists, because it allows for rapid noninvasive assessment of pulmonary status, hemodynamics, cardiac function, and volume status. 

Image of Cardiac Ultrasound

Critical care fellows at Iowa will have access to a state-of-the-art, high-fidelity transthoracic and transesophageal echocardiography (TTE/TEE) simulator as part of their training. The formal critical care echocardiography curriculum at Iowa includes supervised and independent sessions on the TTE/TEE simulator, supervised exams of volunteer model patients, formal instruction on the use of ultrasound equipment currently available for bedside use in our ICUs, didactic lectures, directed readings, informal bedside teaching from faculty in the course of routine patient care, and an expectation that fellows dedicate significant independent time to ultrasonography study. Fellows will be routinely tested on their knowledge of terminology, anatomy, and recognition of pathology, and will be expected to demonstrate proficiency of transducer manipulation and image acquisition on the TTE/TEE simulator. 

An additional elective rotation in clinical echocardiography, that can include hands-on exposure to intra-operative and medical in- or out-patient transesophageal echocardiography as well as proctored interpretation of echocardiographic studies, is available.

By the end of their fellowship, trainees will be expected to able to:

  • Recognize the basic physical principles of Ultrasound image formation and imaging planes;
  • Define terminology involved in probe and transducer manipulation and orientation;
  • Identify common steps required to improve poor image quality;
  • Consistently obtain high-quality standard echocardiograpy views on patients; and save and interpret still- and cine-images from these views;
  • Identify normal and abnormal cardiac, thoracic, abdominal, and vascular anatomy;
  • And apply all these skills to use focused ultrasonography for monitoring patients (for example, to assess intravascular volume status and volume responsiveness) and for diagnosing emergent conditions (such as pneumothorax, significant pulmonary edema, pulmonary embolus or other cause of acute right heart failure, pericardial effusion, a significant decrease in left ventricular function, deep venous thrombosis, and certain intra-abdominal pathology).

Journal Clubs

Journal clubs are held once a month and are attended by fellows and faculty. During each journal club, three fellows will present one article each. Two of these articles will be selected by the fellows from recent literature. The third will be selected from a list of landmark studies that have greatly affected the practice of critical care medicine. In addition to the presentation and an open discussion of the articles, the fellows will also discuss a statistical concept relevant to the chosen article. On a quarterly basis, instead of the standard format, a Pro-Con debate is presented. For this presentation, two fellows will pick a controversial topic related to critical care and present an evidence-based pro-con debate.

Morbidity and Mortality Conference

Once a month a divisional Morbidity and Mortality Conference is held in which three fellows present one case each to the other fellows and faculty with open discussion following the presentations. Approximately every two months, the critical care fellows presents their cases at the Department of Anesthesia’s departmental Morbidity and Mortality Conference, which is held on Wednesdays from 5:00-6:00 PM.

Critical Care Reading Program

A critical care reading program is available to guide fellows self-study. Each week, one chapter from a leading critical care text and 2 influential journal articles are assigned, and fellows meet with faculty every 2 weeks to discuss.  This program effectively covers the breadth of critical care over the one-year fellowship period.