• Aimee J Sarti, Stephanie Sutherland, Andrew Healey, Sonny Dhanani, Michael Hartwick, Simon Oczkowski, David Messenger, Karim Soliman, Ian Ball, Briseida Mema, Mikhail-Paul Cardinal, Sabira Valiani, and Pierre Cardinal.
• Department of Critical Care, Ottawa Hospital, Ottawa, ON, Canada. asarti@toh.ca.
• Can J Anaesth. 2018 Oct 1; 65 (10): 1120-1128.

PurposeTo describe critical care medicine residents' training, expertise, and skills regarding organ and tissue donation processes and procedures.MethodsWe undertook a qualitative multicentre study and employed a purposive sample of program directors, physicians, nurses, residents, and organ donation leaders from all nine academic intensive care unit (ICU) training centres (five adult, four pediatric) in Ontario (n = 71). Interviews, conducted by telephone between December 2015 and March 2016, were audio-recorded and transcribed verbatim. Data collection and analysis were performed using an iterative process and continued until saturation was achieved.ResultsFive main themes were identified: 1) gaps in residents' knowledge for both neurologic determination of death (NDD) and circulatory determination of death (DCD) cases; 2) commitment to the provision of organ and tissue donation training; 3) limited experiential learning (NDD and DCD); 4) challenges related to the provision of training on organ donation and need for a standardized curriculum; and 5) communication with family members. Overall, this study showed system-level gaps in training resulting from the lack of a standardized provincial curriculum on organ donation.ConclusionsQualitative data corroborated that residents need more exposure to clinical cases, especially regarding DCD donors. A standardized education curriculum would be beneficial for all residents within the ICU. Developing a better shared understanding of the donation process will improve team communication and performance, translate into a better end-of-life experience for families, and potentially result in increased donation rates.

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