Transferable training resources for internal medicine trainees: the future of practical procedural training
Introduction
The internal medicine training (IMT) curriculum requires competence by year 3, in 12 practical procedures.1 Traditionally, these have been delivered via a simulation-based education approach allowing skills lab demonstration, familiarisation and practice, before consolidating training in practice.
The COVID-19 pandemic has resulted in reduced educational opportunities for junior doctors, with particular impact on face-to-face training and associated increased remote learning approaches adopted. In order to maintain high standards of education and development for our future medical registrars and consultants, it is essential to create new, adaptive, high quality education models.
This education initiative aimed to firstly, transform and improve procedural skills teaching at a large central London teaching hospital, leading to increased competence among IMT trainees, and secondly, to create and use virtual and transferable teaching resources in order to integrate a flipped learning approach when teaching practical procedures.2
Materials and methods
A survey was carried out to capture trainee-perceived baseline competence: nine video demonstrations were created, comprising curriculum-aligned practical procedures and a procedures handbook was written to complement the videos. All IMTs were sent these resources and post-implementation survey data was subsequently collected.
Results and discussion
Pre-implementation survey (81% response rate) data highlighted a gap in resources. 28% of respondents were IMT1, 48% IMT2 and 24% IMT3; pre-implementation data suggested a delay in perceived clinical competence in those approaching the end of IMT and who were about to embark on higher specialty training. Reported perception of ability and confidence showed a wide range across multiple skills; 5% of trainees reported never having seen a pleural aspiration or drain, or ascitic drain in clinical practice or a skills lab setting. 19% felt independent in performing DC cardioversion (DCCV), 62% independent in performing a lumbar puncture (LP) and 33% in central venous catheter (CVC) insertion.
Nine video demonstrations and the accompanying handbook were distributed as trainee pre-course material prior to a trust procedural skills training day. Post-implementation, a trainee survey (65% response rate) showed an increase in reported confidence across all procedures (Table 1). 42% of respondents were IMT1, 48% IMT2 and 12% IMT3. 65% of respondents reported independent ability to perform a pleural aspiration and 35% a chest drain. 95% independence in ascitic drain insertion was reported, 71% independence in performing DCCV and 47% in performing CVC insertion. 100% of respondents had utilised both resources and would recommend them.
Qualitatively, trainees described the resources as being ‘a helpful quick reference guide before performing procedures on the ward,’ ‘a good concise summary and explanation of what we need to achieve by the end of IMT’ and ‘the resources made SIM more effective as I could focus on the technique as I already understood the procedure.’
Conclusion
The creation of these learning resources has demonstrated a valuable, accessible remote learning resource bank that is now actively utilised in wider training programmes including acute internal medicine registrar procedural training. Further, the resources have been shared with the wider deanery for collective educational purposes across GIM training.
- © Royal College of Physicians 2022. All rights reserved.
References
- ↵
- Joint Royal College of Physicians Training Board
- ↵
- Persky A
Article Tools
Citation Manager Formats
Jump to section
Related Articles
- No related articles found.
Cited By...
- No citing articles found.