KISS in ICU: A Lesson for Online Educators

By Jim Shimabukuro

In an article this morning on, Elizabeth Cohen1 reports that Dr. Mangala Narasimhan, regional director for critical care at Northwell Health in New York, and other doctors “are finding that placing the sickest coronavirus patients on their stomachs — called prone positioning — helps increase the amount of oxygen that’s getting to their lungs.”

Stock photo from Wikimedia Commons.

According to Dr. Narasimhan, “We’re saving lives with this, one hundred percent. It’s such a simple thing to do, and we’ve seen remarkable improvement. We can see it for every single patient.” The downside is that “ventilated patients require more sedation when they’re on their stomachs, which could mean a longer stay in the ICU.” Still, this simple practice is proving effective for patients “who are sickest and have the most to gain from being in that position.” 

The lesson for online educators in these COVID-19 times is that simple may be best practice. Settling on complicated, highly technical, and often costly web-conferencing delivery methods as a blanket solution because everyone else is doing it may be overkill at best and ineffective at worst. The parallel message is that synchronous delivery of instruction via services such as Zoom is not the only or even best solution. They may not be necessary in many cases, and they may actually be inferior to simple asynchronous approaches.

The same holds true for the use of multimedia such as video. Do we, teachers, need to video-record our lectures for viewing by students? Could a simple text version be just as effective? My answers are no and yes. If illustrations are required, photos and screen-captures may suffice. If a video demo is necessary, search YouTube for sources. Chances are good that someone has already created such a video. Link to it or embed it in your site.

Proctored testing services are a complicated and expensive alternative to in-class, in-person exams. They also add cost and inconvenience to student test-takers. The back-to-belly alternative is to dump high-stakes proctored exams in favor of essays or projects.

Returning to the belly flip, ICU workers may want to experiment with other simple solutions, including back-to-side. Could lying on either side improve respiration? For those who are still ambulatory, perhaps brief walks to stimulate respiration? Are there other physical exercises that the not-so-sick could attempt while sitting up in bed? Obviously, I’m not a medical professional, but the point is that breaking away from “official” solutions may be fruitful.

In health care as in education, the emphasis on routine is critical, but the emphasis should also be tampered with creative or innovative practices especially when they’re simpler and just as if not more effective than Rube Goldberg-like procedures.

1 Elizabeth Cohen, “‘Such a simple thing to do’: Why positioning Covid-19 patients on their stomachs can save lives,” CNN, 14 Apr. 2020.

One Response

  1. Hi Jim,

    It certainly is a great time to rethink our courses and how we deliver then. Such rethinking has the added advantage of refreshing old courses.

    As you know, I run into conservative attitudes all of the time. Years ago, my SBIR application was killed by a professor who commented that you cannot do labs online. Period.

    Today, we have educators telling us that our lessons are better than traditional labs.

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