S. S. Kim1, M. O. Meyers1 1University Of North Carolina At Chapel Hill,Department Of Surgery,Chapel Hill, NC, USA
Introduction: Acquisition of procedural skills during medical school continues to evolve. In this study, we examine the impact of the 4th year on actual and desired procedural competence.
Methods: Under IRB approval, we conducted a survey of 3rd and 4th year students over a three-year period. Experience, actual and desired levels of competence were measured for nine procedural skills using a 4-point Likert scale (1=unable to perform; 2= major assistance; 3= minor assistance; 4=independent). Responses were compared by Fisher’s exact test.
Results: 4th year students in 2012 reported a greater number of procedures performed for every skill assessed as compared to 2011 3rd year students (p<0.001 for all); 2013 4th years reported greater numbers only for NG(p=0.01), intubation(p,0.001), IV(p<0.001), Art(p<0.001), LP(p<0.001) and Thor(p=0.04). Actual skill level for selected procedures is reported in the table. 2011 3rd year students desired greater competence than their graduating counterparts for Foley(p=0.01), NG(p=0.003), venipuncture(p=0.006), IV(p=0.002), Art p=0.0005) and LP(p=0.003). In 2012 this was true only for IV(p=0.03). For no skill was there a greater level of actual or desired competence by 4th year students. A greater level of desired competence than actual competence was seen in both 3rd and 4th year for all skills (p<0.001).
Conclusion: No difference in competence was seen between 3rd and 4th year students, despite having greater experience at the end of 4th year. Interestingly, 3rd year students were more likely to desire a higher level of independence with procedures than their 4th year counterparts. Both groups desire a greater level of competence than they accomplish.
