Perspectives of Recent Graduates on Clerkship Procedural Skill Training at a Canadian Medical School: an Exploratory Study

Valeriano, A.; Kim, Andrew; Katsoulas, Eleni; Sanfilippo, Anthony J.; Wang, Louie; Rajaram, Akshay

doi:10.1007/s40670-021-01313-y

Cited by 4 publications

(6 citation statements)

References 25 publications

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“…Teaching procedural skills with routine practice allows learners to effectively achieve as well as maintain a competency [ 15 ]. Moreover, a standardized training program with clear objectives creates safer and more competent physicians as well as reduces learner anxiety [ 16 ]. However, in contrast to this recommendation, there is growing interest for trainees to participate in self-directed learning (SDL) [ 17 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…This occurs when an instructor becomes overburdened by the number of assessments they are required to complete in a CBME training program. As a result, they are not completed in a timely manner or provide limited beneficial feedback [ 16 ]. A solution to trainer feedback fatigue is optimizing the type as well as length of assessments performed [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…As a result, they are not completed in a timely manner or provide limited beneficial feedback [ 16 ]. A solution to trainer feedback fatigue is optimizing the type as well as length of assessments performed [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

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Barriers and enablers to achieving clinical procedure competency-based outcomes in a national paediatric training/residency program—a multi-centered qualitative study

Khan,

Twomey,

Ryan

et al. 2023

BMC Med Educ

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Background In 2018, the Royal College of Physicians of Ireland revised its paediatric training program to a competency-based medical education (CBME) training/residency curriculum. This included a requirement to achieve competence in a number of core procedural skills to progress within the program. Internationally, simulation-based medical education (SBME) is gaining interest as an effective teaching pedagogy for training procedural skill competency. The objectives of this study were to (1) identify enablers and barriers for paediatric trainees to achieve their required procedural competencies, (2) gain insight on the feasibility of achieving the required procedural skills, and (3) explore what simulation-based resources are used as well as their role in achieving the required procedural skill competencies. Methods A multi-centered qualitative study using semi-structured interviews was performed. Twenty-four paediatric consultants and trainees were recruited from two academic tertiary hospitals using purposive and snowball sampling. Interviews were conducted between March and September 2021, audio recorded, transcribed, and analyzed using thematic analysis. Results Three main themes regarding enablers for achieving procedural competencies were reported and include having protected training time, routine assessments, and a standardized curriculum. Barriers to achieving procedural competencies focused mainly on limited clinical exposure. The use of SBME was recommended by all participants (n = 24, 100%) to assist in achieving procedural competencies and most (n = 15, 62.5%) reported it is feasible to attain the required procedural skills in the paediatric CBME program. Conclusion It is feasible to achieve the required procedural competencies for most paediatric trainees, but this can be improved with protected training time, routine assessments, and a standardized curriculum. Barriers to achieving these skills mainly center on limited clinical exposure, which can be remedied by SBME. Further research is warranted to determine the costs and types of SBME tools available as well as teaching pedagogies to support paediatric trainees achieve their required procedural competencies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Barriers and enablers to achieving clinical procedure competency-based outcomes in a national paediatric training/residency program—a multi-centered qualitative study

Khan,

Twomey,

Ryan

et al. 2023

BMC Med Educ

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“…However, basic clinical skills acquisition during clerkships occurs in a rather "haphazard" fashion [ 6 , 8 – 12 ]. Practicing invasive procedures on patients without proper training imposes an ethical issue [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Pre-clerkship procedural training in venipuncture: a prospective cohort study on skills acquisition and durability

Kodikara,

Seneviratne,

Premaratna

2023

BMC Med Educ

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Background The effectiveness of simulation-based training for skill acquisition is widely recognized. However, the impact of simulation-based procedural training (SBPT) on pre-clerkship medical students and the retention of procedural skills learned through this modality are rarely investigated. Methods A prospective cohort study was conducted among pre-clerkship medical students. Learners underwent SBPT in venipuncture in the skills laboratory. Assessments were conducted at two main points: 1) immediate assessment following the training and 2) delayed assessment one year after training. Learner self-assessments, independent assessor assessments for procedural competency, and communication skills assessments were conducted in both instances. The students were assessed for their competency in performing venipuncture by an independent assessor immediately following the training in the simulated setting and one-year post-training in the clinical setting, using the Integrated Procedural Protocol Instrument (IPPI). The student’s communication skills were assessed by standardized patients (SP) and actual patients in the simulated and clinical settings, respectively, using the Communication Assessment Tool (CAT). Results Fifty-five pre-clerkship medical students were recruited for the study. A significant increase was observed in self-confidence [mean: 2.89 SD (Standard Deviation) (0.69)] and self-perceived competency [mean: 2.42 SD (0.57)] in performing venipuncture, which further improved at the delayed assessment conducted in the clinical setting (p < 0.001). Similarly, the IPPI ratings showed an improvement [immediate assessment: mean: 2.25 SD (1.62); delayed assessment: mean: 2.78 SD (0.53); p < 0.01] in venipuncture skills when assessed by an independent assessor blinded to the study design. A significant difference (p < 0.01) was also observed in doctor-patient communication when evaluated by SPs [mean: 2.49 SD (0.57)] and patients [mean: 3.76 SD (0.74)]. Conclusion Simulation-based venipuncture training enabled students to perform the procedure with confidence and technical accuracy. Improved rating scores received at a one-year interval denote the impact of clinical training on skills acquisition. The durability of skills learned via SBPT needs to be further investigated.

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“…Although some skills, such as cardio-pulmonary resuscitation, can be taught in skills labs, medical students need to practice most procedures in the clinical setting (8). However, opportunities for gaining clinical experience are now on a decline (9)(10)(11)(12)(13).…”

mentioning

confidence: 99%

Identifying essential procedural competencies for medical students: a modified Delphi survey

Kodikara,

Seneviratne,

Premaratna

2023

Preprint

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Background Although medical students need to acquire specific procedural skills during their undergraduate training, agreement on what skills they should be trained upon and the competency levels that need to be achieved in these skills is inconclusive. This study aimed to identify core procedural skills competencies for Sri Lankan medical students and establish the importance of pre-clerkship procedural training to improve these skills. Methods A three-round, online modified Delphi survey was used to identify consensus on essential procedural skills and competencies for graduating medical students in Sri Lanka. An initial questionnaire was developed using content identified from the literature and student logbooks. The expert panel included seventeen clinicians involved in undergraduate medical education and supervision of resident physicians. In Round 1, they rated their agreement on including 64 procedural skills, and 4 suggested additional procedures in undergraduate training. In Round 2, experts re-appraised 38 skills and rated the level of competency (i.e., Observer to Proficient). In Round 3, experts re-appraised the ratings of 35 essential procedures and rated the support for a pre-clerkship procedural curriculum for medical students. Results Consensus, defined as > 75% agreement, was established with 25 procedural skills across eight categories: cardiovascular, respiratory, gastrointestinal, surgical, gynecology and obstetrics, urogenital, diagnostic, and injections. Nasogastric tube insertion, venipuncture, handwashing, nose/throat/wound swab, measuring capillary packed cell volume, surgical scrub, gown, and gloving were rated with the highest level of agreement as requiring a 'proficient' level of competency. A majority of the experts were in support of a pre-clerkship procedural curriculum for medical students. Conclusions The findings from this Delphi survey provide critical information about core procedural skills and competencies for Sri Lankan undergraduate medical curricula. The results support the importance of teaching these procedures within the pre-clerkship years of medical curricula. Including highly experienced clinician educators in the expert panel validates the study findings, which demonstrate the importance of aligning existing medical curricula with competency-based medical education.

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Perspectives of Recent Graduates on Clerkship Procedural Skill Training at a Canadian Medical School: an Exploratory Study

Cited by 4 publications

References 25 publications

Barriers and enablers to achieving clinical procedure competency-based outcomes in a national paediatric training/residency program—a multi-centered qualitative study

Barriers and enablers to achieving clinical procedure competency-based outcomes in a national paediatric training/residency program—a multi-centered qualitative study

Pre-clerkship procedural training in venipuncture: a prospective cohort study on skills acquisition and durability

Identifying essential procedural competencies for medical students: a modified Delphi survey

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