Skip to main content

Main menu

  • Home
  • Our journals
    • Clinical Medicine
    • Future Healthcare Journal
  • Subject collections
  • About the RCP
  • Contact us

Future Healthcare Journal

  • FHJ Home
  • Content
    • Current
    • Ahead of print
    • Archive
  • Author guidance
    • Instructions for authors
    • Submit online
  • About FHJ
    • Scope
    • Editorial board
    • Policies
    • Information for reviewers
    • Advertising

User menu

  • Log in

Search

  • Advanced search
RCP Journals
Home
  • Log in
  • Home
  • Our journals
    • Clinical Medicine
    • Future Healthcare Journal
  • Subject collections
  • About the RCP
  • Contact us
Advanced

Future Healthcare Journal

futurehosp Logo
  • FHJ Home
  • Content
    • Current
    • Ahead of print
    • Archive
  • Author guidance
    • Instructions for authors
    • Submit online
  • About FHJ
    • Scope
    • Editorial board
    • Policies
    • Information for reviewers
    • Advertising

Procedural skills training for medical registrars – is it needed?

Bavithra Vijayakumar, Jamie Kitt, Gareth Hynes, Sarah Millette and Michael Fitzpatrick
Download PDF
DOI: https://doi.org/10.7861/fhj.7.1.s110
Future Healthc J February 2020
Bavithra Vijayakumar
AOxford University Hospitals NHS Foundation Trust, Oxford, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jamie Kitt
AOxford University Hospitals NHS Foundation Trust, Oxford, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Gareth Hynes
AOxford University Hospitals NHS Foundation Trust, Oxford, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Sarah Millette
AOxford University Hospitals NHS Foundation Trust, Oxford, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Michael Fitzpatrick
AOxford University Hospitals NHS Foundation Trust, Oxford, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
Loading

Introduction

The Royal College of Physicians’ Acute Care Toolkit 81 recommends that procedural training should be available for medical registrars at all hospitals, and simulation training is widely regarded as a key way of teaching such skills.2 Simulation training is now mandated for foundation and core medicine training / internal medicine training stage 1 trainees nationally,3 and is well delivered locally within our deanery. There is no such facility for general internal medicine (GIM) registrars, so we aimed to determine the interest, need, and pilot the delivery of such training in the procedures outlined by the Joint Royal Colleges of Physicians Training Board (2017).4

Materials and methods

An online survey was sent to GIM trainees within the Thames Valley Deanery in January 2019. Semi-structured interviews were conducted using convenience sampling between February and March 2019 to further explore the issues.

71 responses to the online survey were received and six semi-structured interviews were conducted. Almost 70% of trainees felt current procedural training within the deanery to be inadequate. Trainees had limited exposure to procedures (Fig 1).

Fig 1.
  • Download figure
  • Open in new tab
  • Download powerpoint
Fig 1.

Number of procedures performed by trainees in the past 12 months.

Ad-hoc procedural training during on calls was limited by lack of supervision and service demands, and despite half seeking additional training opportunities, confidence levels were low (Fig 2).

Fig 2.
  • Download figure
  • Open in new tab
  • Download powerpoint
Fig 2.

Trainee confidence in performing a procedure unsupervised.

Key factors affecting trainee confidence included a lack of frequent exposure and medico-legal concerns.

90% of trainees felt simulation training would improve their confidence levels and identified small group size, good facilitators, protected time and a relaxed environment as being important to running an effective simulation session.

Using these results, we trialled a simulation programme for GIM SpRs with the aims of augmenting trainee confidence and providing evidence of basic competency training. Three pilot sessions were run across two sites from September to October 2019. Sessions lasted 3.5 hours, with trainees rotating through the following four stations: abdominal paracentesis/ knee aspiration (station 1), chest drain insertion (station 2), DC cardioversion/ pacing (station 3) and central line insertion (station 4). Trainers were Level 3 competency senior registrars who perform the procedures regularly as part of their clinical practice.

The first pilot had 2 trainees per station and using feedback from the first pilot, the second and third pilots were expanded to 3 trainees per station. VAS score assessment of confidence was performed pre and post session by each trainee for each individual skill.

Results and discussion

32 trainees attended across both sites. Trainee grade ranged from ST3–ST7. Excellent feedback was obtained, with all trainees commenting ‘the sessions were well organised, relevant to clinical practice and improved procedural skills.’ All trainees rated the training as ‘excellent’ and a ‘great initiative’ with 97% recommending incorporation into the HST curriculum. Confidence was improved by VAS scoring post training for all procedures and almost 90% felt the sessions would improve safety on GIM on calls.

Conclusion

Simulation training is an effective way to improve trainee confidence and competence in procedural skills2 and this pilot showed such training is relevant, desired and necessitated across HST in GIM. Further work will assess its impact on maintaining trainee skillsets and its impact on patient safety.

Conflicts of interest

None declared.

  • © Royal College of Physicians 2020. All rights reserved.

References

    1. The Royal College of Physicians
    . Acute care toolkit 8: The medical registrar on call: maximizing clinical experience, training and patient care. London: RCP, 2013. www.rcplondon.ac.uk/guidelines-policy/acute-care-toolkit-8-medical-registrar-call [Accessed 25 October 2019].
  1. ↵
    1. Cartier V
    , Inan C, Zingg W, et al. Simulation-based medical education training improves short and long-term competency in, and knowledge of central venous catheter insertion: A before and after intervention study. Eur J Anaesthiol 2016;33:568–74.
    OpenUrl
  2. ↵
    1. Purva M
    , Fent G, Prakash A. Enhancing UK Core Medical Training through simulation-based education: an evidence-based approach A report from the joint JRCPTB/HEE Expert Group on Simulation in Core Medical Training. NHS, 2016. www.jrcptb.org.uk/sites/default/files/HEE_Report_FINAL.pdf [Accessed 25 October 2019].
  3. ↵
    1. Joint Royal College of Physicians Training Board
    . GIM ARCP decision aid August 2017. London: JRCPTB, 2017. www.jrcptb.org.uk/sites/default/files/GIM%20ARCP%20Decision%20Aid%20%28August%202017%29.pdf [Accessed 25 October 2019].
Back to top
Previous articleNext article

Article Tools

Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Citation Tools
Procedural skills training for medical registrars – is it needed?
Bavithra Vijayakumar, Jamie Kitt, Gareth Hynes, Sarah Millette, Michael Fitzpatrick
Future Healthc J Feb 2020, 7 (Suppl 1) s110-s111; DOI: 10.7861/fhj.7.1.s110

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Procedural skills training for medical registrars – is it needed?
Bavithra Vijayakumar, Jamie Kitt, Gareth Hynes, Sarah Millette, Michael Fitzpatrick
Future Healthc J Feb 2020, 7 (Suppl 1) s110-s111; DOI: 10.7861/fhj.7.1.s110
del.icio.us logo Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Introduction
    • Materials and methods
    • Results and discussion
    • Conclusion
    • Conflicts of interest
    • References
  • Figures & Data
  • Info & Metrics

Related Articles

  • No related articles found.
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Millennial learners – a blended approach to simulation for sepsis
  • Preparing to be the medical registrar on call: the evolution of a simulation programme
  • Mind wandering affects learning – students’ perspective
Show more Education, Training and medical professionalism

Similar Articles

FAQs

  • Difficulty logging in.

There is currently no login required to access the journals. Please go to the home page and simply click on the edition that you wish to read. If you are still unable to access the content you require, please let us know through the 'Contact us' page.

  • Can't find the CME questionnaire.

The read-only self-assessment questionnaire (SAQ) can be found after the CME section in each edition of Clinical Medicine. RCP members and fellows (using their login details for the main RCP website) are able to access the full SAQ with answers and are awarded 2 CPD points upon successful (8/10) completion from:  https://cme.rcplondon.ac.uk

Navigate this Journal

  • Journal Home
  • Current Issue
  • Ahead of Print
  • Archive

Related Links

  • ClinMed - Home
  • FHJ - Home

Other Services

  • Advertising
futurehosp Footer Logo
  • Home
  • Journals
  • Contact us
  • Advertise
HighWire Press, Inc.

Follow Us:

  • Follow HighWire Origins on Twitter
  • Visit HighWire Origins on Facebook

Copyright © 2021 by the Royal College of Physicians