Not Like They Used To: The Decline of Procedural Competency in Medical Training

Area of Science:

• Medical Education
• Pediatrics
• Healthcare Systems

Background:

• Physician training has evolved, with current pediatric residents performing fewer procedures than previous generations.
• Factors such as evolving clinician roles, technological advancements, and work hour restrictions have impacted procedural skill acquisition.
• This decline in procedural competence poses risks to patients, healthcare systems, and physicians.

Purpose of the Study:

• To highlight the decline in pediatric trainees' procedural competence.
• To identify contributing factors to this decline.
• To propose strategies for enhancing procedural skill development in pediatric training.

Main Methods:

• The author draws upon personal experience as a pediatrician trained before current restrictions.
• Analysis of the impact of changing healthcare landscapes on trainee skill acquisition.
• Proposal of educational interventions based on identified needs.

Main Results:

• Trainees today rarely perform many procedures that were once standard.
• A significant decline in procedural competence among pediatric trainees is observed.
• Negative consequences are evident for patient outcomes, healthcare efficiency, and physician well-being.

Conclusions:

• Re-emphasizing the importance of technical skills in pediatric training is crucial.
• Simulation, live training, and mentorship are recommended strategies.
• Scheduled opportunities for procedural practice are essential for competency.