A one-week internal medicine procedure rotation designed to increase procedural opportunities and competency

Link to article at PubMed

Hosp Pract (1995). 2021 Jul 22. doi: 10.1080/21548331.2021.1959747. Online ahead of print.


BACKGROUND: Mounting literature describes increased procedure volume and improvement in procedural skills following implementation of procedural curricula and standardized rotations, generally requiring at least two weeks and incorporating dedicated lecture and didactic efforts. It is unknown whether shorter rotations that feature self-directed curricula can achieve similar outcomes.

METHODS: Housestaff participated in a one-week procedure rotation that coincided with pre-existing non-clinical blocks ("jeopardy"). It provided an online curriculum as well as opportunities to perform procedures under interprofessional supervision. Inpatient procedure volumes were tallied before and after implementation of the rotation. During the first year of the rotation (academic year 2013-2014), housestaff completed a knowledge-based quiz and a Likert-based survey (range 1-5) addressing confidence in performing procedures and satisfaction in procedural training.

RESULTS: Ninety-five of 99 housestaff participated in the intervention (96% response rate). The total number of procedures performed by the Division of Hospital Medicine increased from an average of 74 per year over the four years prior to the introduction of the rotation to 291 per year during the third year of the rotation. The knowledge-based quiz score improved from a pre-intervention mean value of 50% to a post-intervention mean value of 61% (P = 0.020). Confidence in performing procedures improved from a pre-intervention mean value of 2.37 to a post-intervention mean value of 2.59 (P <0.001). Satisfaction with procedural training improved from a pre-intervention mean value of 2.48 to a pre-intervention mean value to the post-intervention mean value of 2.69 (P <0.001).

CONCLUSIONS: A one-week procedure rotation with a self-directed curriculum was introduced into the curriculum of an internal medicine residency program and was associated with increased procedure volume and sustained improvement in housestaff knowledge, confidence, and satisfaction with procedural training.

PMID:34291702 | DOI:10.1080/21548331.2021.1959747

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