Ambulatory Care Skills: Do Residents Feel Prepared?

Area of Science:

• Medical Education
• Ambulatory Care
• Internal Medicine Residency Training

Background:

• Ambulatory care settings are crucial for comprehensive medical training.
• Resident proficiency in ambulatory care skills directly impacts patient care quality.
• Existing data on resident self-perceived competence in these areas is limited.

Purpose of the Study:

• To assess resident comfort and skill levels in performing key ambulatory care skills.
• To identify specific areas of deficiency in resident training for outpatient settings.

Main Methods:

• A descriptive survey was administered to internal medicine faculty and residents at an academic medical center.
• Respondents rated their ability and comfort with physical exams, procedures, counseling, and patient history taking using a 4-point Likert scale.
• Data were analyzed comparing self-rated skills by gender, residency year, faculty status, and predicted skill usage.

Main Results:

• Residents reported high ability in general physical exam skills but lower confidence in specialized exams (musculoskeletal, neurologic, eye).
• Low self-rated ability was reported for procedures, and low comfort was noted for common outpatient counseling.
• Residents expressed higher comfort in obtaining patient history, with minimal variation observed across demographic and usage factors.

Conclusions:

• Self-reported ability and comfort with numerous ambulatory care skills are suboptimal among internal medicine residents.
• These findings highlight a potential gap in outpatient medical training curricula.
• Further investigation in diverse residency programs is necessary to validate and address these self-perceived skill deficits.