Advancing ICU Patient Workup Skills and Readiness With Educational Redesign

Introduction: Faculty redesigned patient workup from self-directed to systems-based in a Critical Care Pharmacy elective course to enhance third-year pharmacy students’ skills in developing patient care plans for critically ill patients. This approach addresses each organ system, organizes their thoughts for a patient presentation, and helps to ensure each laboratory value and/or signs or symptoms are addressed. Students were lectured on an ICU topic, and, given a patient case, they organized a system-based assessment and plan for five patient cases. A system-based framework, rubric, and examples of assessments and plans were provided to students. Faculty provided feedback and grading on each workup prior to completing the next assignment.


Methods: Student academic performance in the course offerings with systems-based workup (2024 and 2025) were compared to the previous year (2023). Comparisons between individual readiness quizzes (IRATs), final exams, and final grades were performed using t-tests. Performance on systems-based patient workups was also assessed via an ANOVA and Tukey's HSD test, and perception of readiness for advanced pharmacy practice experiences (APPEs) was also surveyed via a 4-point Likert scale at the end of the course.


Results: Fifty students completed the course with systems-based workups compared to 25 with self-directed workups. There was a significantly higher performance on the Burn ICU IRAT with the system-based workups (73.6% vs. 91.2%, p=0.002). No other differences in academic performance measured were noted with an average final grade of A-. Performance on the patient workups improved over time; all mean grades for patient workups were significantly higher after the first one. When asked their perception of readiness to work up an ICU patient, students in the systems-based workup cohort responded that they agreed (23/50, 46%) or strongly agreed (13/50, 26%) that they were ready.


Conclusions: This teaching innovation led to a positive perception of readiness for ICU patient workup on APPEs, and individual readiness was improved for the Burn ICU topic. No other change in academic performance were noted, however, evidence of skills progression was also observed after faculty feedback. Further analysis of common mistakes on patient workup may guide teaching in the course.