title: The surgery clerkship: an opportunity for preclinical credentialing in urinary catheterization.
abstract: BACKGROUND
  At our hospital, medical students lost privileges to perform urinary catheterization because of concern regarding catheter-associated urinary tract infections. We hypothesized that trained medical students could perform urinary catheterization with the same proficiency as licensed practitioners.
  
  
  METHODS
  Medical students completed a credentialing program in urinary catheterization. Prospectively, the rate of catheter-associated urinary tract infections after urinary catheterization performed by medical students was compared with the health system-wide rate of catheter-associated urinary tract infections after urinary catheterization performed by non-medical students using an incidence rate ratio (IRR).
  
  
  RESULTS
  Over 9 months, a total of 432 and 55,401 catheter days accrued in patients who underwent urinary catheterization by medial students and non-medical students, resulting in 1 and 129 catheter-associated urinary tract infections, respectively. The incidence rate of catheter-associated urinary tract infections per 1,000 catheter days was 2.31 in the medical student-placed catheters and 2.33 in the non-MS-placed catheters (IRR = .99, P = .55).
  
  
  CONCLUSIONS
  Preclinical credentialing in urinary catheterization resulted in the reinstatement of urinary catheterization privileges to qualified medical students. Student proficiency in urinary catheterization can match that of licensed practitioners.
authors.affiliation: Department of Surgery, University of Pennsylvania Health System, 3400 Spruce Street, Philadelphia, PA 19104, USA.
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Yang
authors.forename: Caroline E
authors.initials: CE
authors.lastname: Reinke
authors.forename: Mayank K
authors.initials: MK
authors.lastname: Mittal
authors.forename: Craig R
authors.initials: CR
authors.lastname: Kean
authors.forename: Evelyn
authors.initials: E
authors.lastname: Diaz
authors.forename: Neil O
authors.initials: NO
authors.lastname: Fishman
authors.forename: Jon B
authors.initials: JB
authors.lastname: Morris
authors.forename: Rachel R
authors.initials: RR
authors.lastname: Kelz
mesh_terms: D000328:Adult; D002568:Certification; D002982:Clinical Clerkship; D002983:Clinical Competence; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D015994:Incidence; D008297:Male; D016017:Odds Ratio; D015143:Philadelphia / Q000453:epidemiology; D014546:Urinary Catheterization / Q000009:adverse effects / Q000379:methods / Q000592:standards; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000209:etiology*