title: Frequency and confidence in performing clinical skills among medical interns in Kuwait.
abstract: BACKGROUND
  Several investigations suggest inadequate emphasis of basic clinical procedures during internship training. Many trainees had reported lack of competence, while some expressed confidence to manage conditions although not sufficiently experienced.
  
  
  OBJECTIVE
  This study aimed at ascertaining the perceptions of new medical graduates regarding the performance of core clinical skills during training and confidence of performing them later. It also aimed at determining any gender variability in the confidence in performing selected clinical skills in Obstetrics & Gynaecology.
  
  
  METHODS
  Interns trained during 2005/06 responded anonymously to a questionnaire that listed 48 core clinical skills. The 124 subjects eligible for the study comprised graduates from Kuwait (64), other Gulf Cooperation Council countries (29), Ireland (27) and Egypt. They indicated whether they felt confident to perform the skills in future, and the number of times they had performed them during training. We received 91 completed questionnaires.
  
  
  RESULTS
  The majority felt confident in performing routine skills (basic ECG and X-ray interpretations, insertion of intravenous line, inserting urethral catheter and nasogastric feeding). Approximately two thirds had performed generic skills related to emergency resuscitation, with a half of them confident in performing them in the future. A third felt confident in performing artificial ventilation and endotracheal intubation. The confidence to perform common skills in Obstetrics & Gynaecology varied, with no significant gender variation. Approximately a fifth was confident in performing lumbar puncture, needle aspiration of joints, insertion of thoracic drainage, insertion of central venous catheter, venous cut-down and indirect laryngoscopy. A small proportion reported confidence in performing different clinical procedures although they had not undertaken them during training.
  
  
  CONCLUSIONS
  Substantial proportions of trainees lacked confidence in performing emergency resuscitative measures and some routine clinical skills. Training needs to be closely monitored and interns who are not competent identified early for taking remedial measures.
authors.affiliation: Kuwait Institute for Medical Specialization, Kuwait.
authors.forename: I G
authors.initials: IG
authors.lastname: Premadasa
authors.forename: Diaa
authors.initials: D
authors.lastname: Shehab
authors.forename: Khaled F
authors.initials: KF
authors.lastname: Al-Jarallah
authors.forename: Lukman
authors.initials: L
authors.lastname: Thalib
mesh_terms: D002983:Clinical Competence; D004503:Education, Medical, Graduate; D004534:Egypt; D005260:Female; D006801:Humans; D007396:Internship and Residency; D007494:Ireland; D007730:Kuwait; D008297:Male; D020377:Self Efficacy; D011795:Surveys and Questionnaires