Document Detail


Gaps in procedural experience and competency in medical school graduates.
MedLine Citation:
PMID:  20053213     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The goal of undergraduate medical education is to prepare medical students for residency training. Active learning approaches remain important elements of the curriculum. Active learning of technical procedures in medical schools is particularly important, because residency training time is increasingly at a premium because of changes in the Accreditation Council for Graduate Medical Education duty hour rules. Better preparation in medical school could result in higher levels of confidence in conducting procedures earlier in graduate medical education training. The hypothesis of this study was that more procedural training opportunities in medical school are associated with higher first-year resident self-reported competency with common medical procedures at the beginning of residency training. METHODS: A survey was developed to assess self-reported experience and competency with common medical procedures. The survey was administered to incoming first-year residents at three U.S. training sites. Data regarding experience, competency, and methods of medical school procedure training were collected. Overall satisfaction and confidence with procedural education were also assessed. RESULTS: There were 256 respondents to the procedures survey. Forty-four percent self-reported that they were marginally or not adequately prepared to perform common procedures. Incoming first-year residents reported the most procedural experience with suturing, Foley catheter placement, venipuncture, and vaginal delivery. The least experience was reported with thoracentesis, central venous access, and splinting. Most first-year residents had not provided basic life support, and more than one-third had not performed cardiopulmonary resuscitation (CPR). Participation in a targeted procedures course during medical school and increasing the number of procedures performed as a medical student were significantly associated with self-assessed competency at the beginning of residency training. CONCLUSIONS: Recent medical school graduates report lack of self-confidence in their ability to perform common procedures upon entering residency training. Implementation of a medical school procedure course to increase exposure to procedures may address this challenge.
Authors:
Susan B Promes; Saumil M Chudgar; Colleen O'Connor Grochowski; Philip Shayne; Jennifer Isenhour; Seth W Glickman; Charles B Cairns
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Academic emergency medicine : official journal of the Society for Academic Emergency Medicine     Volume:  16 Suppl 2     ISSN:  1553-2712     ISO Abbreviation:  Acad Emerg Med     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2010-01-07     Completed Date:  2010-04-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9418450     Medline TA:  Acad Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S58-62     Citation Subset:  IM    
Copyright Information:
(c) 2009 by the Society for Academic Emergency Medicine.
Affiliation:
Department of Emergency Medicine, University of California San Francisco, San Francisco, CA, USA. susan.promes@ucsf.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Clinical Competence / statistics & numerical data*
Emergency Medicine / education*
Humans
Internship and Residency
United States

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