ICU onboarding, boot camp, and procedural readiness curricula as entry-phase competency development for residents and fellows entering adult critical care: A scoping review.

INTRODUCTION

Entry into an adult intensive care unit (ICU) requires adaptation to unstable physiology, invasive support, local workflows, team roles, and supervision practices. We mapped onboarding, orientation, boot camp, and procedural-readiness curricula for residents and fellows entering adult critical care.

METHODS

We conducted a prospectively registered scoping review (OSF DOI: 10.17605/OSF.IO/H2SN4). PubMed/MEDLINE, Web of Science Core Collection, Scopus, CINAHL Plus with Full Text, and ERIC were searched on April 25, 2026 and updated through September 10, 2026. Embase was searched on September 10, 2026 to address its omission from the initial search. Supplementary citation and gray-literature searches were conducted. Records were independently screened by two reviewers, with third-reviewer adjudication when required. Intervention and landscape/needs studies were synthesized separately.

RESULTS

Following database updates, the corrective Embase search, and eligibility re-adjudication, 31 reports representing 26 independent studies and five linked reports were included. Twenty-three studies evaluated interventions and three were landscape/needs studies; 20 interventions were entry-window and three were entry-anchored longitudinal. Non-mutually exclusive outcome mapping identified Level 1 outcomes in 14 studies, Level 2a in 15, Level 2b in 14, Level 3 in 2, Level 4a in 1, and Level 4b in 1. Twelve independent studies were conference-abstract-only.

CONCLUSIONS

Adult critical care entry curricula were heterogeneous and predominantly US-based. Technical and respiratory readiness were the largest evidence clusters, although nonprocedural transition domains were also represented. No superior curriculum model was identified; workplace-transfer evidence was uncommon, and patient-level evidence was limited to one uncontrolled airway-program evaluation.