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

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: House staff participated in a one-week procedure rotation that coincided with preexisting 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), house staff 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 house staff 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 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 house staff knowledge, confidence, and satisfaction with procedural training.