title: Competence and confidence with basic procedural skills: the experience and opinions of fourth-year medical students at a single institution.
abstract: OBJECTIVE
  Data indicate that students are unprepared to perform basic medical procedures on graduation. The authors' aim was to characterize graduating students' experience with and opinions about these skills.
  
  
  METHODS
  In 2011, an online survey queried 156 fourth-year medical students about their experience with, and actual and desired levels of competence for, nine procedural skills (Foley catheter insertion, nasogastric tube insertion, venipuncture, intravenous catheter insertion, arterial puncture, basic suturing, endotracheal intubation, lumbar puncture, and thoracentesis). Students self-reported competence on a four-point Likert scale (4=independently performs skill; 1=unable to perform skill). Data were analyzed by analysis of variance and Student t test. A five-point Likert scale was used to assess student confidence.
  
  
  RESULTS
  One hundred thirty-four (86%) students responded. Two skills were performed more than two times by over 50% of students: Foley catheter insertion and suturing. Mean level of competence ranged from 3.13±0.75 (Foley catheter insertion) to 1.7±0.7 (thoracentesis). A gap in desired versus actual level of competence existed for all procedures (P<.0001). There was a correlation between the number of times a procedure had been performed and self-reported competence for all skills except arterial puncture and suturing.
  
  
  CONCLUSIONS
  Participants had performed most skills infrequently and rated themselves as being unable to perform them without assistance. Strategies to improve student experience and competence of procedural skills must evolve to improve the technical competency of graduating students because their current competency varies widely.
authors.affiliation: Department of Surgery, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina 28599-7213, USA.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Dehmer
authors.forename: Keith D
authors.initials: KD
authors.lastname: Amos
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Farrell
authors.forename: Anthony A
authors.initials: AA
authors.lastname: Meyer
authors.forename: Warren P
authors.initials: WP
authors.lastname: Newton
authors.forename: Michael O
authors.initials: MO
authors.lastname: Meyers
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002983:Clinical Competence / Q000592:standards / Q000706:statistics & numerical data*; D004504:Education, Medical, Undergraduate / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D009657:North Carolina; D020377:Self Efficacy; D057566:Self Report; D013337:Students, Medical / Q000523:psychology*