End of the "see one, do one, teach one" era: The next generation of invasive bedside procedural instruction

Joshua D Lenchus

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Context: Traditionally, an apprenticeship model has been used for the instruction of invasive bedside procedures. Because this approach is subject to nonuniform application, a new model was established to determine the impact of a standardized curriculum on medical students' and residents' medical knowledge and technical skills. Methods:A procedural instruction curriculum for medical students and residents was developed, and a pilot program with the curriculum was incorporated into an internal medicine residency program. Five common procedures in osteopathic and allopathic internal medicine training programs were included: central venous catheterization, knee arthrocentesis, lumbar puncture, paracentesis, and thoracentesis. An initial assessment of participants' baseline knowledge and skills was obtained. Teaching methods included video instruction; discussion of key concepts; faculty-led, hands-on, simulationbased instruction; and individual deliberate practice. Postinstruction knowledge and skills were evaluated, respectively, through a written test and a quantified assessment (ie, checklist) using direct observation. Participants were asked to provide written feedback at the conclusion of each instructional module. Results: A total of 60 participants, all in allopathic medicine, underwent the training component. Fifty-two participants were internal medicine residents (including 2 from an outside program); 4 were trainees in a combined internal medi - cine-pediatrics residency; and 4 were medical students (1 from an outside program). Participants demonstrated a statistically significant improvement (P<.001) in medical knowledge, as evidenced by preinstruction vs postinstruction test scores. Comparison of initial baseline procedural checklist scores with postinstruction checklist scores, during participants' performance on the first live patient, also showed statistically significant improvement (P<.001). Conclusion: A simulation-based, standardized curriculum in invasive bedside procedural instruction significantly improved the medical knowledge and technical skills of novice physicians.

Original languageEnglish
Pages (from-to)340-346
Number of pages7
JournalJournal of the American Osteopathic Association
Volume110
Issue number6
StatePublished - Jun 1 2010

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Curriculum
Internal Medicine
Checklist
Medical Students
Internship and Residency
Central Venous Catheterization
Paracentesis
Spinal Puncture
Knee
Teaching
Observation
Medicine
Pediatrics
Physicians
Education

ASJC Scopus subject areas

  • Complementary and alternative medicine
  • Medicine(all)

Cite this

End of the "see one, do one, teach one" era : The next generation of invasive bedside procedural instruction. / Lenchus, Joshua D.

In: Journal of the American Osteopathic Association, Vol. 110, No. 6, 01.06.2010, p. 340-346.

Research output: Contribution to journalArticle

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