Procedural knowledge and skills of residents entering canadian family medicine programs in Alberta

Abstract

BACKGROUND AND OBJECTIVES: Incoming family medicine (FM) residents start residency with different levels of procedural training. Understanding their baseline skill level is necessary to plan the educational experiences and teaching methods that will provide the desired knowledge, skills, and attitudes related to performing medical procedures. METHODS: A survey of 69 procedures based on the core list issued by the College of Family Physicians of Canada was administered to incoming residents in Alberta (Calgary and Edmonton FM programs). The survey intended to identify the levels of training and confidence acquired for each listed procedure before residency, and plans to perform each of the procedures in future independent practice. RESULTS: A total of 146 residents from both programs responded to the survey (82% response rate). Of the 69 procedures evaluated, 15 (21.7%) had been previously performed at least five times by 50% or more residents. Only five procedures were rated by 80% or more of the residents as being able to perform independently or to teach to others: simple suture, infiltration of local anesthetic, intramuscular injection, cryotherapy of skin lesions and Pap smear. More male residents than female residents felt confident in performing 10 procedures, while female residents were more confident in performing Pap smears. Rural residents felt more confident to perform 22 procedures than their urban colleagues. CONCLUSIONS: This information demonstrates limited prior training in procedures among entering residents, and provides guidance to FM programs to develop teaching interventions to achieve competence in those procedural skills seen as necessary for family physicians.