Residency onboarding: Be sure your students are on the same page

Dr. Eddy admits that it’s surprising that some institutions consider it sufficient to read about a procedure and pass a test. Residents need only exposure to the procedure but don’t have to demonstrate competence in it.

Hospitals and health systems must also consider the safety factor. Incorrectly executed procedures can lead to unintended hospitalizations, healthcare-acquired infections (HAIs), and even patient deaths. While institutions recognize this and file safety reports if there are errors, it’s always preferable to maintain high-quality patient safety standards by ensuring that procedures are learned and performed correctly.

Be creative with initiatives, resources to aid in learning procedures

Since virtual interviews are continuing for this year’s new residents, PDs must find new ways to determine levels of medical school preparation as well as instructional methods to help them attain a standard proficiency in completing procedures. Dr. Eddy likes a strategy her institution is trying with its new residents:

“In an effort to better understand levels of development, this year’s incoming interns completed individualized learning plans in collaboration with their medical school advisor, indicating where they felt more or less prepared. We passed that information along to their residency advisors.”

Using evidence-based simulations in medical residency

To equip residents for hands-on patient care, Dr. Eddy recommends using simulations for procedures — “The first time an intern does a procedure should not be on a real person” — and sharing procedures, with a resident starting the procedure, then supervising the intern who completes it.

It’s more important than ever to have standardized teaching materials available to residents and to the faculty. When it comes to didactic education on performing procedures, Dr. Eddy notes that non-in-person resources are still “very scattered.” Yes, it may be easy for an intern or resident to find a YouTube video on how to place a central line. But do they notice the source of the video or know the competency of the person performing it? Is that video demonstrating best practices?

Your internal medicine residency program needs consistent, evidence-based, step-by-step guidance in teaching medical procedures. Dr. Eddy is excited about the increasing availability of professionally developed videos, like Lippincott Medical Procedures, that give residents a standard foundation for learning and perfecting patient procedures. These videos can be built into a program’s instructional schedule, viewed independently by the residents, or a combination of the two.

Preparing resident students for practice

Take a look at your internal medicine residency program and how it prepares your interns and residents. Is there consistency in how they’re learning the fundamentals, like patient procedures? Do they feel confident and empowered as they develop their patient care practice? Do your residents and faculty have the right educational resources to mitigate risk, reduce variability of care, and maintain compliance?

It’s time to move beyond the “see one, do one, teach one” methodology of medical procedure instruction so all residents in your program learn, perform, and master procedures at the same level of competency.