The educational environment for training in intensive care medicine: structures, processes, outcomes and challenges in the European region

Objective: To characterise the training environment in ICM across Europe, with a particularfocus on factors influencing competency-based training. Method: Across-sectional web-based surveycompleted by the national coordinator for the CoBaTrICE (Competency-Based Training in Intensive Care medicine programme in each of 28 European countries. Results: Sincethe last survey in 2004, 50% of EU countries have modified their training programmes. Seven have alreadyadopted the CoBaTrICE programmesince its completion in 2006. Multidisciplinary access to ICM training(‘supraspeciality’ model) is available in 57%, most commonly as a 2-yeartraining programme. National examinations are held by 26 (93%); in 24 (86%) this is a mandatory exit exam;ten use the European Diploma of Intensive Care (EDIC). A formal national system for quality assurance of ICM training exists in only 18(64%) countries. National standards for approving hospitals as trainingcentres vary widely. In 29% there is no designated specialist with responsibilityfor training at the local level. Time for teaching was cited as inadequate by 93% of respondents; only21% of trainers receive contractual recognition for their work. In 39% there is no protected teaching time fortrainees. Half of countries surveyed have no formal system for workplacebasedassessment of competence oftrainees. Conclusions: There is considerable diversity in pedagogic structures, processes and qualityassurance of ICM across Europe.National training organisationsshould develop common standards forquality assurance, health systemsneed to invest in educator support,and the EU should facilitate harmonisation by recognising ICM as amultidisciplinary speciality.