Formal Procedural Instruction for Residents — An Opportunity for Academic Hospitalists

1University of Miami Miller School of Medicine, Miami, FL

Meeting: Hospital Medicine 2008, April 3-5, San Diego, Calif.

Abstract number: 112


Residents often feel inadequately instructed to perform invasive procedures and believe this poses a risk to patients. Formal teaching using task trainers (ie, models) has the potential to improve competence and confidence, and advance patient safety.


To describe the development and initial evaluation of an innovative pilot program to teach internal medicine residents to perform 5 invasive bedside procedures.


Beginning in July 2007, residents participated in a dedicated program during which they learned 5 invasive bedside procedures: lumbar puncture, thoracentesis, paracentesis, knee arthrocentesis, and ultrasound‐guided central venous catheter insertion. This instruction is a required component of a 2‐ or 4‐week rotation designed to improve patient safety through reducing complications, improve education through direct multidisciplinary faculty instruction, and bolster resident confidence and competence. Each resident followed a formal curriculum that included assessment of baseline medical knowledge and technical skills, procedural struction, and subsequent practice on models. The residents then made up a procedure team dedicated to performing the above procedures for various hospital services. Supervising hospitalist faculty evaluated the residents on their technique of performing the procedures on hospitalized patients, using the same checklist that was implemented during the training portion. After the rotation, residents completed a questionnaire to assess satisfaction with the rotation, perceived competence, and confidence in performing invasive procedures.


Between July and December 2007, 24 second‐ and third‐year medicine residents participated in the training program. For all procedures, there was a statistically significant increase in postintervention scores. The end‐of‐rotation questionnaire universally identified an improvement in self‐assessed confidence and competence. We developed an innovative, standardized, simulation‐based educational initiative that improved procedural competence and confidence of internal medicine residents. This type of formal instruction has the potential to reduce risk to patients and physicians associated with the most common invasive bedside procedures performed by internal medicine residents.

Author Disclosure:

J. Lenchus, none.

To cite this abstract:

Lenchus J. Formal Procedural Instruction for Residents — An Opportunity for Academic Hospitalists. Abstract published at Hospital Medicine 2008, April 3-5, San Diego, Calif. Abstract 112. Journal of Hospital Medicine. 2008; 3 (suppl 1). Accessed April 8, 2020.

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