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. 2019 Jul 1:6:2382120519859298.
doi: 10.1177/2382120519859298. eCollection 2019 Jan-Dec.

Ambulatory Training Program to Expand Procedural Skills in Primary Care

Robert J Fortuna  1   2 , Bethany Marston  1   2   3 , Susan Messing  4 , Gunnar Wagoner  1   2 , Tiffany L Pulcino  1   2 , Todd Bingemann  1   2 , Enrico Caiola  1   2 , Steven Scofield  1   2 , Karen Nead  1   2 , Brett W Robbins  1   2
Affiliations

Ambulatory Training Program to Expand Procedural Skills in Primary Care

Robert J Fortuna et al. J Med Educ Curric Dev. .

Abstract

Introduction: Outpatient procedures are an important component of primary care, yet few programs incorporate procedural training into their curriculum. We examined a 4-year procedural curriculum to improve understanding of ambulatory procedures and increase the number of procedures performed.

Methods: A total of 56 resident and 8 faculty physicians participated in a procedural curriculum directed at joint injections (knee, shoulder, elbow, trochanteric bursa, carpal tunnel, wrist, and ankle), subdermal contraceptive insertion/removal, skin biopsies, and ultrasound use in primary care. We administered annual surveys and used generalized estimating equations to model changes.

Results: Across the 4 years, there was an average 96% response rate. Mean comfort level with the indications for procedures increased for both resident (62.5 to 78.8; P < .0001) and faculty physicians (61.5 to 94.8; P < .0001). Similarly, mean comfort with performing procedures increased for both resident (32.1 to 62.3; P < .0001) and faculty physicians (42.2 to 85.4; P < .0001). Residents' comfort level performing procedures increased for all individual procedures measured. The mean number of procedures performed per year increased for resident (1.9 to 8.2; P < .0001) and faculty physicians (14.7 to 25.2; P = .087).

Conclusions: A longitudinal ambulatory-based procedural curriculum can increase resident and faculty physician understanding and comfort performing primary-care-based procedures. This, in turn, increased the total number of procedures performed.

Keywords: Education; ambulatory; joint injection; primary care; procedures; ultrasound.

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Conflict of interest statement

Declaration of conflicting interests:The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Comfort level with indications for procedures for (A) residents and (B) faculty. CL indicates confidence limit.
Figure 2.
Figure 2.
Comfort level with performing procedures for (A) residents and (B) faculty. CL indicates confidence limit.
Figure 3.
Figure 3.
Number of procedures performed by (A) residents and (B) faculty. CL indicates confidence limit.
See this image and copyright information in PMC

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