Evaluation of obstetrics procedure competency of family medicine residents

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Abstract

Objective: To establish a procedure evaluation system to monitor residents’ improvement in obstetrics (OB) procedures performance and skills during the training period. Methods: A web-based procedure logging and evaluation system was developed using Microsoft.net technology with a SQL server as a backend database. Residents’ logged OB procedures were captured by the system. The OB procedures logged within 7 days were evaluated by supervising faculty using three observable outcomes (procedure competency, procedure-related medical knowledge level, and patient care). Results: Between 1 July 2005 and 30 June 2008, a total of 8543 procedures were reported, of which 1263 OB procedures were evaluated by supervising faculty. There were significant variations in the number of logged procedures by gender, residency track, and US versus non-US medical graduates. Approximately 84% of the procedures were performed (independently or with assistance) by residents. Residents’ procedure skills, procedure-related medical knowledge, and patient care skills improved over time, with significant variations by gender among the three outcomes. Conclusion: The benefits of specific evaluation of procedural competence in postgraduate medical education are well established. Innovative and reliable tools to assess and monitor residents’ procedural skills are warranted.

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Diabetes prevalence and therapeutic target achievement in the United States, 1999 to 2006.

Bernard Cheung, Kwok Leung Ong, Stacey S Cherny … (2009)

Changes in the prevalence, treatment, and management of diabetes in the United States from 1999 to 2006 were studied using data from the National Health and Nutrition Examination Survey. Data on 17,306 participants aged 20 years or more were analyzed. Glycemic, blood pressure, and cholesterol targets were glycosylated hemoglobin less than 7.0%, blood pressure less than 130/80 mm Hg, and low-density lipoprotein (LDL) cholesterol less than 100 mg/dL, respectively. The prevalence of diagnosed diabetes was 6.5% from 1999 to 2002 and 7.8% from 2003 to 2006 (P < .05) and increased significantly in women, non-Hispanic whites, and obese people. Although there were no significant changes in the pattern of antidiabetic treatment, the age-adjusted percentage of people with diagnosed diabetes achieving glycemic and LDL targets increased from 43.1% to 57.1% (P < .05) and from 36.1% to 46.5% (P < .05), respectively. Glycosylated hemoglobin decreased from 7.62% to 7.15% during this period (P < .05). The age-adjusted percentage achieving all 3 targets increased insignificantly from 7.0% to 12.2%. The prevalence of diagnosed diabetes increased significantly from 1999 to 2006. The proportion of people with diagnosed diabetes achieving glycemic and LDL targets also increased. However, there is a need to achieve glycemic, blood pressure, and LDL targets simultaneously.

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Observational tools for assessment of procedural skills: a systematic review

Kamran Ahmed, Danilo Miskovic, Ara Darzi … (2011)

Assessment by direct observation of procedural skills is an important source of constructive feedback. The aim of this study was to identify observational tools for technical skill assessment, to assess characteristics of these tools, and to assess their usefulness for assessment.

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Procedural skills in medicine: linking theory to practice.

G. Kovacs (1997)

Emergency departments offer a unique educational setting where housestaff can be exposed to and learn a variety of procedural skills. However, procedural skills are often overlooked as an assumed activity without a formal educational context. The clinical educator's understanding of the educational principals of teaching and learning procedural skills is minimal. This review offers further insight. The "psychomotor domain," which represents a hierarchy of learning motor skills, and relevant motor learning theory extracted from the educational psychology literature are reviewed. These theoretical considerations can be adapted to and provide useful information relevant to procedural medicine. Issues of curriculum content, methods of teaching and learning, and issues of competence relevant to the creation of a procedural skill program are reviewed and discussed.