Confidence of graduating internal medicine residents to perform ambulatory procedures

Wickstrom, Glenda C.; Kolar, Maria M.; Keyserling, Thomas C.; Kelley, David K.; Xie, Sharon X.; Bognar, Bryan A.; Lewis, Carmen L.; DuPre, Connie T.; Wickstrom, G C; Kolar, M M; Keyserling, T C; Kelley, D K; Xie, S X; Bognar, B A; Lewis, C L; DuPre, C T
June 2000
JGIM: Journal of General Internal Medicine;Jun2000, Vol. 15 Issue 6, p361
Academic Journal
journal article
Objective: To evaluate the training of graduating internal medicine residents to perform 13 common ambulatory procedures, 3 inpatient procedures, and 3 screening examinations.Design: Self-administered descriptive survey.Setting: Internal medicine training programs associated with 9 medical schools in the eastern United States.Participants: Graduating residents (N = 128); response rate, 60%.Measurements and Main Results: The total number of procedures performed during residency, importance for primary care physicians to perform these procedures, confidence to perform these procedures, and helpfulness of rotations for learning procedures were assessed. The majority of residents performed only 2 of 13 outpatient procedures 10 or more times during residency: simple spirometry and minor wound suturing. For all other procedures, the median number performed was 5 or fewer. The percentage of residents attributing high importance to a procedure was significantly greater than the percentage reporting high confidence for 8 of 13 ambulatory procedures; for all inpatient procedures, residents reported significantly higher confidence than importance. Continuity clinic and block ambulatory rotations were not considered helpful for learning ambulatory procedures.Conclusions: Though residents in this sample considered most ambulatory procedures important for primary care physicians, they performed them infrequently, if at all, during residency and did not consider their continuity clinic experience helpful for learning these skills. Training programs need to address this deficiency by modifying the curriculum to ensure that these skills are taught to residents who anticipate a career in primary care medicine.


Related Articles

  • Internists: more specialists or more generalists? Rogers, David E.; Rogers, D E // Annals of Internal Medicine;May85, Vol. 102 Issue 5, p702 

    Editorial. Looks at the number of physicians that are entering internal medicine training in the U.S. in 1985. Percentage of internal medicine residents that elected subsequent subspecialty training in 1985; Patterns of ambulatory care in internal medicine in 1981.

  • Confidence of academic general internists and family physicians to teach ambulatory procedures. Wickstrom, Glenda C.; Kelley, David K.; Keyserling, Thomas C.; Kolar, Maria M.; Dixon, James G.; Xie, Sharon X.; Lewis, Carmen L.; Bognar, Bryan A.; DuPre, Connie T.; Coxe, David R.; Hayden, Juliana; Williams, Mark V.; Wickstrom, G C; Kelley, D K; Keyserling, T C; Kolar, M M; Dixon, J G; Xie, S X; Lewis, C L; Bognar, B A // JGIM: Journal of General Internal Medicine;Jun2000, Vol. 15 Issue 6, p353 

    Objective: To evaluate and compare the readiness of academic general internal medicine physicians and academic family medicine physicians to perform and teach 13 common ambulatory procedures.Design: Mailed survey.Setting: Internal medicine and family...

  • Million more outpatients heading for primary care.  // Pulse;4/7/2003, Vol. 63 Issue 14, p4 

    Reports that one million more outpatients will be seen in primary care when the new general practitioner contract is implemented, according to a British government dossier on future National Health Service funding.

  • Long-term outcomes of anthroposophic treatment for chronic disease: a four-year follow-up analysis of 1510 patients from a prospective observational study in routine outpatient settings. Hamre, Harald Johan; Kiene, Helmut; Glockmann, Anja; Ziegler, Renatus; Kienle, Gunver Sophia // BMC Research Notes;2013, Vol. 6 Issue 1, p1 

    Background: Anthroposophic treatment includes special artistic and physical therapies and special medications. We here report an update to a previously published study of anthroposophic treatment for chronic diseases, including more patients and a longer follow up. The Anthroposophic Medicine...

  • PERSPECTIVES: Principles to Consider in Defining New Directions in Internal Medicine Training and Certification. Turner, Barbara J.; Centor, Robert M.; Rosenthal, Gary E. // JGIM: Journal of General Internal Medicine;Mar2006, Vol. 21 Issue 3, p276 

    SGIM endoreses seven principles related to current thinking about internal medicine training: 1) internal medicine requires a full three years of residency training before subspecialization; 2) internal medicine residency programs must dramatically increase support for training in the ambulatory...

  • Performance of an ambulatory casemix measurement system in primary care in Spain. Juncosa, Sebastián; Bolíbar, Bonaventura; Roset, Montserrat; Tomás, Rosa // European Journal of Public Health;Mar1999, Vol. 9 Issue 1, p27 

    Evaluates the performance of ambulatory care groups used in primary care in Spain. Information on patient classification systems in an ambulatory setting; Use of age, sex and diagnoses of the episodes of care of patients; Results and discussion.

  • Ambulance trip to ED often wrong option for patient. Castaneda, Reynald // New Zealand Doctor;4/24/2013, p8 

    The article reports on the benefits of redirecting ambulances to primary care in New Zealand.

  • Using the Primary Care Assessment Survey in an Ambulatory Setting. Hartley, Lou Ann // Nursing Economic$;Sep/Oct2002, Vol. 20 Issue 5, p235 

    Provides information on the Primary Care Assessment Survey (PCAS), a survey designed to operationalize the Institute of Medicine's definition of primary care. Use of the PCAS to assess access of patients to ambulatory settings to document short-term and long-term outcomes of care; Areas of...

  • Communication breakdown in the outpatient referral process. Gandhi, Tejal K.; Sittig, Dean F.; Franklin, Michael; Sussman, Andrew J.; Fairchild, David G.; Bates, David W.; Gandhi, T K; Sittig, D F; Franklin, M; Sussman, A J; Fairchild, D G; Bates, D W // JGIM: Journal of General Internal Medicine;Sep2000, Vol. 15 Issue 9, p626 

    Objective: To evaluate primary care and specialist physicians' satisfaction with interphysician communication and to identify the major problems in the current referral process.Design: Surveys were mailed to providers to determine satisfaction with the referral process;...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics