Procedural Skills Training In The Internal Medicine Residency In Iran: A National Survey Of Recent Graduates Of Residency Programs

Background: procedural skills training is an important part of internal medicine residency and knowing which procedures residents are  performing and  the quality  of their  training is a necessary step to ensure sufficient training opportunities.Purpose: To obtain the opinions of recent  graduates of residency  programs of internal medicine in Iran about  the quality of training in procedural skills.Method: A questionnaire was given by hand  to the all 187 general internists who had graduated from 22 universities of medical sciences in 2003. Thirty-three ambulatory and inpatient procedures were included in the questionnaire. For each skill the newly graduated internists were asked to answer questions about: the number of procedure they have done during  their  residency, level of supervision they  received  during  performing the  procedure, level of confidence to performing it independently. quality of training and level of importance for a general internist to do it independently. They also were asked to rate the overall quality of procedural skills training and their overall competency to perform these skills. Finally they were asked to answer open questions regarding: Assessment of their procedural skills competency during residency training. Introducing useful references and Materials by residency Programs, the most important problems in their Training and suggestions for improving the quality of procedural skills training.Three postal and an email (for those who have email addresses) reminders were sent for nonresponders.Results: 57/187 (30%) questionnaires were analyzed. More than 50% of   respondents said that the quality of teaching procedural skills were not adequate. Meanwhile only 32% of respondents believe that Their competencies in performing procedures are well or more. Statistical difference has been observed between male and female regarding  their ideas about competencies to performing procedures (p<0.001).Only 36% of respondents recall that their performance on procedures had been evaluated. which nearly all of them in only 1 procedure. Eleven procedures were indicated by 90% or more of the respondents as those should be learned by all the graduates.Conclusion: Current residency training in internal medicine does not assure the minimum competency of graduates in most of the more important procedural skills. Residency programs must pay more attention to teaching procedural skills to the residents and assessing their competence.