Matthew J Rustici, MD - University of Colorado; Stephen Wolf, MD - Denver Health Medical Center; Maria Moreira, MD - Denver Health Medical Center; Jason Brainard, MD - University of Colorado
Background: Choice of procedural skills (PS) taught to medical students is often dictated by faculty discretion or the 8 AAMC recommended skills (Foley placement, NG placement, venopuncture, IV placement, arteriopuncture, suturing, lumbar puncture, and thoracentesis). Studies have examined opinions of 3rd and 4th year medical students as to which PS should be taught in medical school but some common skills performed in residency have not been assessed. No studies have looked at whether pediatric students needs differ from those of general medical students.
Goal: We conducted a needs assessment survey of fourth-year medical students regarding importance of training in various PS.
Methods: Data were collected using an electronic anonymous survey of fourth-year medical students at the University of Colorado. 83 students completed the survey (53% response rate); 9 were entering Pediatrics (75% of students matching in Pediatrics). Participants used a 5-point Likert scale to rank the importance (1- not important, 5- very important) of receiving training in 23 specific PS during medical school. Data were analyzed descriptively to compare needs of students entering Pediatrics with needs of students entering other fields.
Results: Both pediatric students and students entering other fields ranked the following skills as very important (median = 5): arterial line placement, central venous line placement, suturing, lumbar puncture, and endotracheal intubation. There were no additional skills noted by non-pediatrics students as being "very important", however, students entering pediatrics also felt incision and drainage, arteriopuncture, chest tube placement and bag-mask ventilation were very important. Pediatric students rated the other AAMC recommended PS (NG placement, venopuncture, IV placement and thoracentesis) as important (median =4) and foley placement as neutral (median = 3).
Discussion: Students entering residencies in Pediatrics at our institution have similar opinions to other students about which PS should be taught in medical school, however, these opinions differ somewhat from AAMC recommendations. We used these data to design a fourth-year elective in procedural skills that is open to all students and focuses on airway management, central vascular access, laceration repair and fluid sampling (LP and thoracentesis), addressing all PS rated "very important" by all medical students and many PS recommended by the AAMC. Further studies should seek to resolve differences between expert and student opinions in PS training, as well as evaluate outcomes of PS training as interns begin residency.