A blended approach to invasive bedside procedural instruction

作者：Lenchus Joshua^*; Issenberg S Barry; Murphy Daniel; Everett Thomas Ruth; Erben Laura; Arheart Kristopher; Birnbach David J

来源：Medical Teacher, 2011, 33(2): 116-123.

DOI：10.3109/0142159X.2010.509412

Objective: This study assessed the impact of a blended, standardized curriculum for invasive bedside procedural training on medical knowledge and technical skills for Internal Medicine residents.
Methods: The investigators developed a curriculum in procedural instruction and performance for Internal Medicine house staff, and implemented the program at a tertiary care academic medical center with a primary affiliation with a US medical school. The investigators chose procedures recommended for technical competence by the American Board of Internal Medicine: lumbar puncture, thoracentesis, paracentesis, central venous catheter insertion, and knee arthrocentesis. The program included: (1) assessment of baseline medical knowledge and technical proficiency on mannequins, (2) video instruction of procedure, (3) faculty-led discussion of critical concepts, (4) faculty demonstration of the procedure on mannequin, (5) individual practice on simulators, (6) post-intervention knowledge evaluation, and (7) post-intervention skills evaluation. The performance achieved during the initial skills evaluation on a mannequin was compared to the performance achieved on the first patient subsequent to the instructional portion.
Results: All participants with complete data demonstrated a statistically significant pre-intervention to post-intervention improvement (p < 0.05) in comprehensive medical knowledge and procedural skills.
Conclusion: A blended, standardized curriculum in invasive bedside procedural instruction can significantly improve performance in participants'' medical knowledge and technical skills.

• 出版日期2011