Are commonly used resident measurements associated with procedural skills in internal medicine residency training?
BACKGROUND
Acquisition of competence in performing a variety of procedures is essential during Internal Medicine (IM) residency training.


OBJECTIVE
Determine the rate of procedural complications by IM residents; determine whether there was a correlation between having 1 or more complications and institutional procedural certification status or attending ratings of resident procedural skill competence on the American Board of Internal Medicine (ABIM) monthly evaluation form (ABIM-MEF). Assess if an association exists between procedural complications and in-training examination and ABIM board certification scores.


METHODS
We retrospectively reviewed all procedure log sheets, procedural certification status, ABIM-MEF procedural skills ratings, in-training exam and certifying examination (ABIM-CE) scores from the period 1990-1999 for IM residency program graduates from a training program.


RESULTS
Among 69 graduates, 2,212 monthly procedure log sheets and 2,475 ABIM-MEFs were reviewed. The overall complication rate was 2.3/1,000 procedures (95% CI: 1.4-3.1/1,000 procedure). With the exception of procedural certification status as judged by institutional faculty, there was no association between our resident measurements and procedural complications.


CONCLUSIONS
Our findings support the need for a resident procedural competence certification system based on direct observation. Our data support the ABIM's action to remove resident procedural competence from the monthly ABIM-MEF ratings.
Durning
Steven J
SJ
Department of Medicine (NEP), Uniformed Services University, Bethesda, MD 20814, USA. sdurning@usuhs.mil
Cation
Lannie J
LJ
Jackson
Jeffrey L
JL
D002568:Certification / Q000379:methods / Q000592:standards; D002983:Clinical Competence / Q000592:standards*; D004521:Educational Measurement / Q000379:methods / Q000592:standards; D006801:Humans; D007388:Internal Medicine / Q000193:education* / Q000379:methods / Q000592:standards*; D007396:Internship and Residency / Q000379:methods / Q000592:standards*; D012189:Retrospective Studies