Learning, experience, and self-assessment of competence of third-year medical students in performing bedside...

Third-year medical students are expected to perform common bedside procedures as part of their daily ward activities, but there are few programs to teach these skills or document students' abilities to perform them.

In addition to describing the clinical procedures course at the Medical College of Georgia School of Medicine, the purpose of this paper is to report how often students perform common bedside procedures during the third year of medical school, whether the number of times a procedure has been performed is indicative of self-perceived level of competence, and how useful the students find the procedures course for learning how to perform common procedures.

In June 1991, the 163 entering third-year students participated in a two-day course in which they were taught universal precautions and provided specific step-by-step instructions for performing 16 clinical procedures. One year later, after the students had completed their third-year clerkships, they were asked to report the numbers of times they had performed the procedures during their clerkships, to provide self-assessments of their competency, and to indicate how helpful the course had been for learning clinical procedures. The association between the number of times the students reported performing a procedure and how competent they felt to perform the procedure was assessed using Kendall's tau coefficient.

A total of 100 students returned completed questionnaires. Most of the students reported performing venipuncture, obtaining blood cultures, and scrubbing surgically more than five times, but they reported performing other procedures less frequently. For most procedures, self-assessment of competency correlated with frequency of performance. The procedures course was well received by students and instructors, based on both written evaluations and informal verbal feedback.

Surprisingly, the students' self-reports indicated that many students performed procedures on patients infrequently. As expected, for most procedures there was a significant association between frequency of performance and self-assessed competency.