ABSTRACT
BACKGROUND
Procedures form a core competency for internists, yet many do not master these skills during residency. Simulation can help fill this gap, but many curricula focus on technical skills, and overlook communication skills necessary to perform procedures proficiently. Hybrid simulation (HS) is a novel way to teach and assess procedural skills in an integrated, contextually-based way.
AIM
To create a HS model for teaching arthrocentesis to internal medicine residents.
SETTING
Internal medicine residency program at the University of Toronto.
PARTICIPANTS
Twenty four second-year internal medicine residents.
PROGRAM DESCRIPTION
Residents were introduced to HS, given practice time with feedback from standardized patients (SPs) and faculty, and assessed individually using a different scenario and SP. Physicians scored overall performance using a 6-point procedural skills measure, and both physicians and SPs scored communication using a 5-point communication skills measure.
PROGRAM EVALUATION
Realism was highly rated by residents (4.13/5.00), SPs (4.00) and physicians (4.33), and was perceived to enhance learning. Residents’ procedural skills were rated as 4.21/6.00 (3.00 – 5.00; ICC = 0.77, [0.53 – 0.92]), comparable to an experienced post-graduate year (PGY) 2-3; and all but one resident was considered competent.
DISCUSSION
HS facilitates simultaneous acquisition of technical and communication skills. Future research should examine whether HS improves transfer of skills to the clinical setting.
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Acknowledgements
Contributors: We would like to thank Diana Tabak and Karen Delaney-Laupacis from the Standardized Patient Program for their assistance in planning and executing the session.
Funders:
This study was funded by a grant from the Department of Medicine Professors Research and Education Fund, University of Toronto and the Education Development Fund, Faculty of Medicine, University of Toronto; a 25th Anniversary Project Award from the Standardized Patient Program, University of Toronto; and Herbert Ho-Ping-Kong Centre for Excellence in Education and Practice.
Prior presentations:
Preliminary results from this study were presented at the RCPSC International Conference on Residency Education in Ottawa on September 24, 2010.
Conflict of Interest
The authors declare that they do not have a conflict of interest.
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Stroud, L., Cavalcanti, R.B. Hybrid Simulation for Knee Arthrocentesis: Improving Fidelity in Procedures Training. J GEN INTERN MED 28, 723–727 (2013). https://doi.org/10.1007/s11606-012-2314-z
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DOI: https://doi.org/10.1007/s11606-012-2314-z