Background: Bedside procedure services are increasingly employed within internal medicine departments to meet clinical needs and improve trainee education.Published literature on these largely comprises single-center studies; an updated systematic review is needed to synthesize available data.Purpose: This review examined published literature on the structure and function of bedside procedure services and their impact on clinical and educational outcomes (PROSPERO ID: 192466). Data Sources: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework, multiple databases were searched for publications from 2000 to 2021.Study Selection, Data Extraction, and Data Synthesis: Thirteen single-center studies were identified, including 12 observational studies and 1 randomized trial. Data were synthesized in tabular and narrative format. Services were typically staffed by hospitalists or pulmonologists. At a minimum, each offered paracentesis, thoracentesis, and lumbar puncture. While there was considerable heterogeneity in service structures, these broadly fit either Model A (service performing the procedure) or Model B (service supervising the primary team). Procedure services led to increases in procedure volumes and self-efficacy among medical residents. Assessment of clinical outcomes was limited by heterogeneous definitions of complication rates and by sparse head-to-head data involving suitable comparators. Published data pointed to high success rates, low complication rates, and high patient satisfaction, with a recent study also demonstrating a decreased length of stay.Conclusions: There are relatively few published studies describing the characteristics of bedside procedure services and their impact on clinical and educational outcomes.Limited data point to considerable heterogeneity in service design, a positive impact on medical trainees, and a positive impact on patient-related outcomes.

Introduction: Although there are standardized assessments of medical students throughout medical school, the clinical experience of each student may vary widely. Currently, medical schools do not have a systematic method to ensure that students perform clinical skills during clinical clerkships. Our study used the Entrustable Professional Activities for Entering Residency (EPAs) framework to assess the ways in which medical students meaningfully participate in patient care at various clinical sites in each required clerkship and over time. Methods: Over the 2020-2021 academic year, 170 third-year medical students were asked to report the number of times they performed EPA-1 (gather history and perform physical examination), EPA-5 (document clinical encounter), and EPA-6 (provide oral presentation of clinical encounter) at the end of each required clinical rotation (emergency medicine, internal medicine, surgery, obstetrics/gynecology, pediatrics, neurology, psychiatry) at a single medical school. We used descriptive statistics and t tests to compare frequency of these EPAs by campus type, site type, clerkship, and time. Results: One thousand, two hundred sixty-one surveys met inclusion criteria. Students performed EPA-5 more often at an academic medical center, and EPA-1 more frequently in the outpatient setting. Students performed EPA-1 and EPA-6 most often during emergency medicine and EPA-5 most often during internal medicine. Performance of all three EPAs increased over time. Conclusion: This reporting system produced a robust data set that allowed for EPA performance comparisons by campus, site type, clerkship, and time. EPA performance varied by rotation, site type, clerkship, and time.