AI-enhanced emergency cardiology induction: a CURACO framework pilot study on critical care competencies and decision-making

Abstract

Abstract Background/Introduction Emergency cardiac care delivery requires rapid, systematic clinical decision-making, yet frontline doctors often experience uncertainty during critical transitions. Traditional induction methods focus primarily on clinical competencies without addressing patient empowerment, healthcare equity, or systematic integration of safety, understanding, research, authenticity, ethics, and technology. Current approaches lack holistic frameworks ensuring both clinical excellence and patient-centred emergency care delivery. Purpose To conduct a pilot evaluation of whether AI-enhanced emergency cardiology induction programmes incorporating CURACO principles (Clinical safety, Understanding, Research-informed care, Authentic patient-centred approaches, Conscientious ethics, and Optimised technology) improve frontline doctors' acute response capabilities while incorporating patient empowerment and equity considerations. Methods We developed AI-enhanced structured acute cardiology induction programmes at Bradford Royal Infirmary, derived from emergency care protocols and enhanced using CURACO principles to ensure safety-first protocols, patient understanding components, research-informed guidelines, authentic care approaches, ethical considerations, and optimised technology integration. The programmes embedded critical care protocols for time-sensitive conditions including STEMI, NSTEMI, cardiogenic shock, and life-threatening arrhythmias. We surveyed resident doctors (n=15) rotating through cardiology from 2023-2024 using 5-point Likert scales across acute care domains before and after implementation. Paired t-tests analysed competency scores. Results All domains showed significant improvements (p<0.001). Understanding of emergency protocols improved substantially (mean difference 2.53), confidence in critical decision-making increased (mean difference 1.80), and preparedness for acute team integration enhanced (mean difference 2.06). The CURACO-enhanced approach demonstrated additional benefits: 93.3% reported enhanced preparedness for managing acute cardiac emergencies. Emergency care guidance received high ratings (4.60/5) and comprehensive coverage of acute scenarios (4.33/5). Patient understanding components were valued by 87% of users, creating a more holistic approach to emergency care training. Conclusion Implementation of CURACO-enhanced AI-generated emergency cardiology induction programmes significantly improved frontline doctors' acute care competencies while incorporating patient empowerment principles. This pilot demonstrates that AI-derived interventions can be transformed through systematic integration of safety, understanding, research, authenticity, ethics, and technology. The CURACO framework provides foundation for developing clinical training serving both clinical excellence and patient-centred emergency care. These findings justify progression to larger studies with patient outcomes and multi-centre validation.

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