Ready or not, here they come: acting interns' experience and perceived competency performing basic medical procedures

Area of Science:

• Medical Education
• Surgical Skills Training
• Internal Medicine Residency

Background:

• Fourth-year medical students (acting interns) at the University of Cincinnati College of Medicine (UCCOM) complete required Internal Medicine rotations.
• Assessing competency in basic medical procedures is crucial for intern preparedness.

Purpose of the Study:

• To evaluate acting interns' (AIs) experience and perceived competency in performing six fundamental medical procedures.
• To identify procedural performance rates and confidence levels among AIs.

Main Methods:

• A survey was administered to 301 AIs across two academic years (2003-2004 and 2004-2005).
• Participants reported on the performance and perceived competency of phlebotomy, IV catheter insertion, arterial blood gas (ABG) sampling, nasogastric (NG) tube insertion, lumbar puncture (LP), and Foley catheter insertion.
• A 78% response rate was achieved with 467 completed surveys.

Main Results:

• Few students performed all procedures, with rates ranging from 9% for Foley catheter insertion to 50% for ABG and NG tube insertion.
• Arterial blood gas (ABG) and nasogastric (NG) tube insertion were the most frequently performed procedures (46-50%).
• Perceived competency varied significantly, from 12% for LP to 82% for Foley catheter insertion. Performing a procedure generally increased confidence, except for LP, where many who performed it still lacked confidence.

Conclusions:

• A significant number of fourth-year medical students do not perform essential procedures during their acting internship rotations.
• Procedural performance directly correlates with students' self-reported feelings of competency.
• Achieving competency in lumbar puncture may be an overly ambitious objective for medical students within the current curriculum structure.