Perception of Competency to Perform Procedures and Future Practice Intent

Abstract

A national survey of family practice (FP) chief residents to identify the type of procedural skills they have completed, assess their perceptions of competence to perform those procedures, and identify the procedures they anticipate performing in practice. A questionnaire asking about training and competency in 31 core procedures for family medicine (FM) was developed from the literature and pilot tested on residency directors for face validity and clarity. The questionnaires were mailed to chief residents at the 463 FM residency programs in the United States between July and October 2001. A total of 265 (57%) questionnaires were returned. Ninety-six percent of respondents were PGY3 seconds, and 40% were women. All residents had performed excision of a lesion, drainage of an abscess, and simple suturing. Residents were least likely to have performed vasectomy (46%), thoracotomy (41%), and rigid sigmoidoscopy (34%). The mean number of procedures performed during residency and the number of procedures the resident intended to perform in practice differed by gender. Residents who planned to practice in rural areas anticipated performing more procedures than did those who planned to practice in suburban areas (20 versus 17; p ≥ .001). Over 90% of residents felt competent to perform obstetrics, but fewer than 50% planned to in practice. Despite reports that core procedural skills are taught, this study suggests significant numbers of residents are not being taught certain procedures in a manner that results in residents feeling competent to perform them.