Teaching Critical Care Q&A: Five Questions with Sheri Crow, MD

Sheri Crow, MD, a pediatric critical care specialist at the Mayo Clinic in Rochester, Minnesota, USA, played a major role in the introduction of the Pediatric Fundamental Critical Care Support (PFCCS) program to healthcare providers in the Republic of Georgia. Here, Dr. Crow speaks more about the project and what she hopes others can learn from it.

Why is the train-the-trainer approach so important for a community such as healthcare workers in the Republic of Georgia?
Throughout Georgia, the lingering influence of the former Soviet Union’s approach to healthcare delivery creates a variety of challenges for the adoption of Western principles. PFCCS is an educational program that was developed and is maintained by the internationally recognized Society of Critical Care Medicine (SCCM). SCCM ownership helps overcome whatever biases might exist against specific Western healthcare institutions and avoids the frustration that develops during encounters with Western visiting professors teaching their own brand of medicine. PFCCS provides a model for training local healthcare workers to become course instructors. These instructors become equipped with a tool for educating their local healthcare networks independent of any foreign involvement.

What was your reaction to the efforts and growth of the six original SCCM-certified PFCCS instructors in Georgia?
We were overwhelmed by the enthusiasm, work ethic, and dedication with which our Georgian colleagues embraced PFCCS course development. Their independent efforts to take the course to other healthcare systems in Georgia between our visits was a testament to the feasibility and sustainability of this approach to advancing critical care management throughout the country.

What do you typically learn from these types of projects?
I’m always amazed at the innovative methods these providers use to effectively battle critical illness without access to the medical technology we regularly take for granted in the United States. These international collaborations always inspire me and provide me with new insight into strategies for optimizing outcomes for my patients at home.

I witness humanity at its best, joining together against the intrusion of critical illness, persevering despite daunting limitations. Ultimately, these heroes provide their patients with the only comfort any of us can really offer, which is the knowledge that their life matters enough to fight death with every available resource, even if we ultimately face defeat. I am reminded that the greatest intervention we can offer our patients is not dependent on high-tech resources or internationally recognized academic accolades, but on our ability to compassionately enter into the struggle our patients and their loved ones face when battling critical illness.

What do you hope others learn from what this project was able to accomplish?
I hope that this project encourages others to consider a vetted, standardized, consistent approach to educational initiatives, such as PFCCS, as a platform for international medical collaborations. SCCM sponsorship provides instant credibility for the fundamental principles discussed. This credibility facilitates diplomatic discussions of practice differences and increases the likelihood of adopting necessary changes.