BACKGROUND: Internists commonly perform invasive procedures, but serious deficiencies exist in procedure training during residency. OBJECTIVE: Evaluate a comprehensive, inpatient procedure service rotation (MPS) to improve Internal Medicine residents' comfort and self-perceived knowledge in performing lumbar puncture, abdominal paracentesis, thoracentesis, arthrocentesis, and central venous catheterization (CVC). DESIGN: The MPS comprised 1 faculty physician and 1-3 residents rotating for 2 weeks. It incorporated lectures, a textbook, instructional videos, supervised practice on mannequins, and inpatient procedures directly supervised by the faculty physician. We measured MPS impact using pre- and post-MPS rotation surveys, and surveyed all residents at academic year-end. MEASUREMENTS AND MAIN RESULTS: Thirty-nine categorical Internal Medicine residents completed the required rotation and surveys over the 2004-2005 academic year, performing 325 procedures. Post-MPS, the percentage of residents reporting comfort performing procedures rose 15-36% (p < .05 except for arthrocentesis, and CVC via internal jugular and femoral veins). The fraction desiring more training fell 26-51% (all p < .05). After the MPS rotation, self-rated knowledge increased in all surveyed aspects of the procedures. The year-end survey showed that improvements persisted. Comfort at year-end, for all procedures except abdominal paracentesis, was significantly higher among residents who rotated through the MPS than among those who had not. Self-reported compliance with recommended antiseptic measures was 75% for residents who completed the MPS, and 28% for those who had not (p < 0.001). CONCLUSIONS: A comprehensive procedure service rotation of 2 weeks duration substantially improved residents' comfort and self-perceived knowledge in performing invasive procedures. These benefits persisted at least to the end of the academic year.
BACKGROUND: Internists commonly perform invasive procedures, but serious deficiencies exist in procedure training during residency. OBJECTIVE: Evaluate a comprehensive, inpatient procedure service rotation (MPS) to improve Internal Medicine residents' comfort and self-perceived knowledge in performing lumbar puncture, abdominal paracentesis, thoracentesis, arthrocentesis, and central venous catheterization (CVC). DESIGN: The MPS comprised 1 faculty physician and 1-3 residents rotating for 2 weeks. It incorporated lectures, a textbook, instructional videos, supervised practice on mannequins, and inpatient procedures directly supervised by the faculty physician. We measured MPS impact using pre- and post-MPS rotation surveys, and surveyed all residents at academic year-end. MEASUREMENTS AND MAIN RESULTS: Thirty-nine categorical Internal Medicine residents completed the required rotation and surveys over the 2004-2005 academic year, performing 325 procedures. Post-MPS, the percentage of residents reporting comfort performing procedures rose 15-36% (p < .05 except for arthrocentesis, and CVC via internal jugular and femoral veins). The fraction desiring more training fell 26-51% (all p < .05). After the MPS rotation, self-rated knowledge increased in all surveyed aspects of the procedures. The year-end survey showed that improvements persisted. Comfort at year-end, for all procedures except abdominal paracentesis, was significantly higher among residents who rotated through the MPS than among those who had not. Self-reported compliance with recommended antiseptic measures was 75% for residents who completed the MPS, and 28% for those who had not (p < 0.001). CONCLUSIONS: A comprehensive procedure service rotation of 2 weeks duration substantially improved residents' comfort and self-perceived knowledge in performing invasive procedures. These benefits persisted at least to the end of the academic year.
Authors: G C Wickstrom; D K Kelley; T C Keyserling; M M Kolar; J G Dixon; S X Xie; C L Lewis; B A Bognar; C T DuPre; D R Coxe; J Hayden; M V Williams Journal: J Gen Intern Med Date: 2000-06 Impact factor: 5.128
Authors: Grace C Huang; C Christopher Smith; Craig E Gordon; David J Feller-Kopman; Roger B Davis; Russell S Phillips; Saul N Weingart Journal: Am J Med Date: 2006-01 Impact factor: 4.965
Authors: R J Sherertz; E W Ely; D M Westbrook; K S Gledhill; S A Streed; B Kiger; L Flynn; S Hayes; S Strong; J Cruz; D L Bowton; T Hulgan; E F Haponik Journal: Ann Intern Med Date: 2000-04-18 Impact factor: 25.391
Authors: T Garrood; A Iyer; K Gray; H Prentice; R Bamford; R Jenkin; N Shah; R Gray; B Mearns; J C Ratoff Journal: Clin Med (Lond) Date: 2010-10 Impact factor: 2.659