Teaching Procedures

CDR John R. Holman, MC, USN

(edited for web page by CDR DL Hufford, MC, USN, 21 JUL 99)

Faculty Development Fellowship

Madigan Army Medical Center

Goals:

1. The learners will understand the process for teaching procedures in the family practice residency setting.

Objectives:

1. The learners will:

• Develop a needs assessment tool for a particular procedure.
• Write achievement-based objectives for their procedure.
• Determine educational strategies for their objectives.
• Discuss strengths and weaknesses of evaluation strategies.

Introduction

We all do procedures in family medicine. Why do we do them? We do them because our patients need these procedures, because we enjoy doing them, and because procedures are good sources of revenue. Family physicians perform procedures, some more than others, in mixes adapted to training, interest and local need . An organized approach to procedure training is needed to acquire the skills and knowledge needed for competency.

Needs Assessment Results

Survey

How many in residency training situations have formal curricula for

• Internal medicine training
• OB/GYN training
• Behavioral Science
• Minor skin surgery
• Flexible sigmoidoscopy
• Colposcopy?

Curriculum Development

In small groups, decide which procedure you want to work on a curriculum for. Decide on a group spokesperson and scribe. This can be changed at any time.

1. Needs assessment-After the brief didactic, in your small group, decide how a needs assessment will be done and how you will assess the needs for the faculty and residents. Share with the group.
2. Goals and Objectives-Following the large group discussion, in your small groups write a goal and at least five achievement-based objectives. Be sure to use an active verb! Share them with the large group.
3. Educational Strategies-Based on the objectives you have just written, in your groups design educational strategies that will allow the learner to complete the objectives. Try to include education involving knowledge, skills and attitudes. Discuss and share as a large group.
4. Evaluation Strategies-Review the objectives and educational strategies in your small groups. Design evaluation strategies to assess the competencies of the residents. Once again, assessing all three components, knowledge, skills and attitudes is important. Clinical competence exists when a practitioner has sufficient knowledge and skill such that a procedure can be performed to obtain intended outcomes without harm to the patient. Share your ideas with the large group.

Conclusion

Good research is still needed to further clarify training and experience needed to perform specific procedures. However, as a discipline, it is time for use to declare victory in the question of whether family physicians should perform procedures. Only family physicians have the breadth of clinical knowledge and skill, the population perspective, and the relationship skills to manage total patient care, assess community needs, design services to meet those needs, and lead the health care team. These are the core skills of every family physician, whatever the range of procedures and inpatient care an individual physician may provide . This is important to keep in mind as we train our future family physicians.

References:

²

³ Weiss B. Family medicine education: counterculture or conservatism? Fam Med 1997;29(2):139-41.

Other helpful references:

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