When Old Habits Train a New Generation: Findings From a National Survey of Internal Medicine Program Directors on Procedural Training

Ricotta, Daniel N; Smith, Carol; Chaudhry, Saima; McDonald, Furman S.; Huang, Grace C.

doi:10.1177/1062860617743786

Cited by 11 publications

(10 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2 The recent changes from ABIM and ACGME have created further ambiguity in the training and assessment of internal medicine resident training in bedside procedures that was noted in a national survey of Program Directors even before these changes. 3 Training and assessments are currently left to be customized by individual Program Directors. Graduating residents will need to perform these procedures as fellows, supervising faculty, or practicing providers, creating potential credentialing and safety concerns.…”

Section: Introductionmentioning

confidence: 99%

Competency‐based assessment of procedural skills in resident training

Meliagros,

Garber,

Sadr

et al. 2023

Journal of Hospital Medicine

View full text Add to dashboard Cite

Background No standardized summative tools exist to assess competency in bedside procedures or provide residents and programs with summative feedback. Objective To provide competency‐based procedure training and feedback to residents, we created a procedure competency committee (PCC). Here, we describe the PCC process, its impact on procedure training, and examine residents' attainment of competency in bedside procedures. Design, Setting, and Participants The PCC consisted of hospitalists and met twice annually to review resident procedure portfolios for three academic years 2019–2022 at a university‐based internal medicine residency program. Residents were designated to one of the five competency levels; being able to participate, perform under supervision with assistance, perform under direct supervision (DS) without assistance, perform independently with indirect supervision (IS), and perform independently with IS and supervise others. We analyzed the probability of advancing competency levels with each additional procedure using multinomial logistic regression models. Results Of the 97 residents, 48 (49.5%) were women and 60 (62%) subsequently matched in procedure‐oriented fields. More residents achieved IS level for paracentesis than for lumbar puncture (LP) or central venous catheterization (CVC) (62 vs. 25 and 37, respectively; p < .001). Each incremental procedure performed was associated with a higher chance of being advanced to IS group from the DS group; 1.31 times for paracentesis (95% confidence interval [CI] = 1.07, 1.60; p < .008), 1.83 times for LP (95% CI = 1.35, 2.47; p = .0001), and two times for CVC (95% CI = 1.32, 3.05; p = .001). Conclusion The PCC provided competency‐based assessment of a resident's procedural skills and may be used to assess the impact of curriculum changes.

show abstract

Section: Introductionmentioning

confidence: 99%

Competency‐based assessment of procedural skills in resident training

Meliagros,

Garber,

Sadr

et al. 2023

Journal of Hospital Medicine

View full text Add to dashboard Cite

show abstract

“…However, this is followed directly by the statement that "not all residents need to perform all procedures," without any clear guidance as to how many of which procedures are indeed essential to internal medicine training 1 . The level of experience, and subsequent competence of graduating residents is largely unknown and studies report signi cant variability in the number of procedures performed as well as comfort level in all stages of training [2][3][4][5][6] . Furthermore, it appears that residents are entering a supervisory role before they are comfortable with doing a procedure.…”

Section: Introductionmentioning

confidence: 99%

“…This potentially leads to complications that could have otherwise been avoided. Unfortunately, as shown in a survey of internal medicine program directors by Ricotta et al, it seems that many internal medicine programs rely on credentialed resident to teach peers despite the fact that being credentialed often meant completing a minimum of only 3-5 procedures 5 .…”

Section: Introductionmentioning

confidence: 99%

Advancing Internal Medicine Training: Experience of a Bedside Procedure Service as a Resident Elective

et al. 2021

View full text Add to dashboard Cite

Background: In 2007, the American Board of Internal Medicine eliminated numeric procedure requirements for licensing. The level of exposure to procedures during residency, and subsequent competence of graduating residents, is variable. In 2015, our institution developed a bedside procedure service (BPS) with the intent to teach ultrasound guidance and procedural training to internal medicine residents with direct supervision of technique by Hospital Medicine faculty to optimize learning, increase con dence, and improve patient safety.Objective: In this study, we review the number and complication rates of resident procedures on a dedicated internal medicine bedside procedure service (BPS) as a resident elective.Methods: In this retrospective, observational, single-center study, we reviewed internally collected data from BPS procedures performed from 2015-2019. The BPS offers a variety of procedures done with ultrasound guidance at an adult tertiary care referral center. BPS services are available to all inpatient hospital services. A rotation with the BPS was offered as a stand-alone resident elective for the rst time in 2015.Results: 69 residents performed a total of 2700 ultrasound-guided/assisted procedures and 146 diagnostic ultrasound scans from 2015-2019. Residents performed an average of 40 procedures during their elective month. There were 5 resident performed procedural complications with an overall complication rate of 0.19%. Conclusions: Our BPS increased procedural opportunities for residents and allowed for real-time feedback by an experienced faculty member in a one-on-one setting. A dedicated rotation allows the time to focus on becoming pro cient in invasive procedures with expert supervision.

show abstract

Section: Introductionmentioning

confidence: 99%

Advancing Internal Medicine Training: Experience of a Bedside Procedure Service as A Resident Elective

Swartz

Reguero

Puetz

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: In 2007, the American Board of Internal Medicine eliminated numeric procedure requirements for licensing. The level of exposure to procedures during residency, and subsequent competence of graduating residents, is variable. In 2015, our institution developed a bedside procedure service (BPS) with the intent to teach ultrasound guidance and procedural training to internal medicine residents with direct supervision of technique by Hospital Medicine faculty to optimize learning, increase confidence, and improve patient safety. Objective: In this study, we review the number and complication rates of resident procedures on a dedicated internal medicine bedside procedure service (BPS) as a resident elective.Methods: In this retrospective, observational, single-center study, we reviewed internally collected data from BPS procedures performed from 2015-2019. The BPS offers a variety of procedures done with ultrasound guidance at an adult tertiary care referral center. BPS services are available to all inpatient hospital services. A rotation with the BPS was offered as a stand-alone resident elective for the first time in 2015. Results: 69 residents performed a total of 2700 ultrasound-guided/assisted procedures and 146 diagnostic ultrasound scans from 2015-2019. Residents performed an average of 40 procedures during their elective month. There were 5 resident performed procedural complications with an overall complication rate of 0.19%.Conclusions: Our BPS increased procedural opportunities for residents and allowed for real-time feedback by an experienced faculty member in a one-on-one setting. A dedicated rotation allows the time to focus on becoming proficient in invasive procedures with expert supervision.

show abstract

When Old Habits Train a New Generation: Findings From a National Survey of Internal Medicine Program Directors on Procedural Training

Cited by 11 publications

References 38 publications

Competency‐based assessment of procedural skills in resident training

Competency‐based assessment of procedural skills in resident training

Advancing Internal Medicine Training: Experience of a Bedside Procedure Service as a Resident Elective

Advancing Internal Medicine Training: Experience of a Bedside Procedure Service as A Resident Elective

Contact Info

Product

Resources

About