Evaluation of Outpatient Procedures Simulation Curriculum for Internal Medicine Residents

Outpatient procedure training in internal medicine residency has not been shown to produce high-level outcomes such as improved volume and quality of procedures performed on real patients.

The objective of this study was to improve the volume and quality of outpatient procedures performed by internal medicine residents by administering a simulation-based curricular intervention.

Validated teaching materials and local faculty input were used to design a simulation curriculum for teaching the knee joint injection/aspiration and skin abscess incision and drainage. A prospective curricular intervention was implemented for a single cohort of internal medicine interns.

All internal medicine interns at Beth Israel Deaconess Medical Center during the 2021-2022 academic year were allowed to participate in this educational intervention with no exclusion criteria.

Forty-seven interns received 30 min of simulation education for each procedure.

Primary outcomes included total number of procedures performed in clinic, volume of procedures performed by residents, percentage of total procedures performed by residents, and procedural success and complication rates before and after the curricular intervention.

At 1-year post-curriculum, the total number of procedures in clinic increased by 25%. Procedures by residents increased by 110%, with joint injections/aspirations increasing by 317% and skin abscess incision and drainage increasing by 200%. Complication rates reduced from 25 to 0%, and 100% of resident-performed procedures post-curriculum were completed successfully.

These findings demonstrate that a novel outpatient procedures simulation curriculum can positively impact higher-level clinical practice outcomes for internal medicine residents.