Teaching procedural skills to family medicine residents: Preliminary report of the Bori experience.
DOI:
https://doi.org/10.30574/gscarr.2021.6.3.0040Keywords:
Training, Skills, Hospital rural, ResidencyAbstract
Introduction: Proficiency in procedural skills is a prerequisite for graduating residents in Family Medicine. The acquisition of these skills required for clinical practice remains an ongoing challenge. In order to overcome the challenge of resident doctors in Family Medicine in acquiring competence in procedural skills, rural posting was added in their curriculum.
Aim: The aim of this study was to evaluate the effect of dedicated teaching of procedural skills on the residents’ performance at the end of their rural posting.
Method: A hospital based cross-sectional study in which respondents were recruited by convenient sample of all consenting residents (n = 29) from two training institutions who reported to the Bori Zonal Hospital for rural posting from 2018-2020. A questionnaire was administered to the respondents. A two sample t-test was used to compare the means and P-value of <0.05 was considered statistically significant.
Result: A total of 728 procedures were performed during the period. The most common procedure performed was caesarean section and the least was repair of vesicovaginal fistula. The mean procedural rating score at the beginning and the end of the rural posting were 1.68±0.70 and 3.94±0.64 respectively. There was a significant difference between the procedure mean scores at the beginning and end of the rural posting (t=11.91, p< 0.0001, 95% confidence interval: -2.6414 to -1.8786).
Conclusion: Given the right training in an enabling environment, the Family Medicine resident graduates proficient in the right mix of skills needed to run district Hospitals and other health institutions.
Metrics
References
Watts RW. The GP proceduralist. Aust Fam Physician. 1993; 22(8): 1475-8.
Sturmberg JP. Procedural skills in general practice: are we going to lose this facet of general practice care? Aust Fam Physician. 1999; 28(12): 1211-2.
Firnhaber J, Kolasa K. A pilot study of training family medicine residents in procedural skills at a community health centre. Fam Med. 2012; 44(3): 202-204.
Ludmerer KM, Johns MM. Reforming graduate medical education. JAMA. 2005; 294(9): 1083-1087.
Lesky LG. The ever-widening training-practice gap. Acad Med. 2007; 82(3): 219-221.
Tsai TC, Harasym PH. Challenges of pediatric residency training in Taiwan. Acta Paediatr Taiwan 2006; 47(1): 3-6.
Flinkenflögel M, Essuman A, Chege P, Ayankogbe O, De Maeseneer J. Family medicine training in sub-Saharan Africa: South–South cooperation in the Primafamed project as strategy for development Fam Pract. 2014 Aug; 31(4): 427–436.
Pories WJ, Aslakson HM. The surgical residency: The job description does not fit the job. Arch Surg 1990; 125: 147-9.
Chaytors RG, Szfran O, Crutcher RA. Rural-urban and gender differences in procedures performed by family practice residency gradu¬ates. Fam Med 2001; 33(10): 766-71.
Esan O, Adeoye A, Onakoya P, Opeodu O, Owonikoko K, Olulana D, Bello M, Adeyemo A, Onigbogi L, Idowu O, Akute T. Features of residency training and psychological distress among residents in a Nigerian teaching hospital. S Afr J Psych 2014; 20(2): 46-50.
Inem AV, Ayankogbe OO, Obazee M, Ladipo MM, Udonwa NE, Odusote K. What Constitutes the Domain of Family Medicine in West Africa. Nig. Medical Practitioner. 2004; 45(3): 33-37.
Pembe A B, Carlstedt A, Urassa D P, Lindmark G, Nyström L, Darj E. Effectiveness of maternal referral system in a rural setting: a case study from Rufiji district, Tanzania. BMC Health Services Research. 2010; 10: 326.
Van der Goes T, Grzybowski SC, Thommasen H. Procedural skills training. Canadian family practice residency programs. Can Fam Physician. 1999; 45: 78-85.
Wetmore SJ, Stewart M. Is there a link between confidence in procedural skills and choice of practice location? Can J Rural Med. 2001; 6(3): 189-4.
Nothnagle M, Sicilia J M, Forman S, Fish J, Ellert W, Gebhard R et al. Required Procedural Training in Family Medicine Residency: A Consensus Statement Fam Med. 2008; 40(4): 248-52.
Doyle JD, Webber EM, Sidhu RS. A universal global rating scale for the evaluation of technical skills in the operating room. The American Journal of Surgery. 2007; 193(5): 551-555.
Yakassai IA, Ibrahim SA, Abubakar IS, Ayyuba R, Mohammed AD, Gajida AU. Surgical procedures in obstetrics and gynaecology departments in a teaching hospital in northern Nigeria, A 5-year review. Arch Int Surgery. 2014; 4: 104-7.
Ameh EA. Surgery in a rural hospital: experience from northern Nigeria. East Afr Med J. 1998; 75(3): 180‐183.
Umunna JI The scope and challenges of rural surgical practice in Nigeria. Niger J Surg. 2011; 17(1): 25-28.
Betran AP, Torloni MR, Zhang J, Ye J, Mikolajczyk R., and others. 2015. What Is the Optimal Rate of Caesarean Section at Population Level? A Systematic Review of Ecologic Studies.” Reproductive Health. 12: 57.
Bandura A. Self-efficacy. In: Ramachaudran VS(Ed.). Encyclopedia of human behavior New York: Academic Press. (Reprinted in H. Friedman(Ed.), Encyclopedia of mental health, San Diego: Academic Press. 1998. p. 71-81.
Fincher RME, Lewis LA. Learning, experience, and self-assessment of competence of third-year medical students in performing bedside procedures. Acad Med. 1994; 69: 291-5.
Taylor DM. Undergraduate procedural skills training in Victoria: is it adequate? Med J. Aust 1997; 166: 251-4.
Hicks CM, Gonzales R, Morton MT, Gibbons RV, Wigton RS, Anderson RJ. Procedural experience and comfort level in internal medicine trainees. J Gen Intern Med. 2007; 15(10): 716-22.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Paul O Dienye, Geraldine U Ndukwu, Alali I Dan-Jumbo, Biralo K. Paul
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.