Journal of General Internal Medicine
Volume 15, Number 6, 353-360, DOI: 10.1046/j.1525-1497.2000.04109.x

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Original Articles

Confidence of academic general internists and family physicians to teach ambulatory procedures

Glenda C. Wickstrom, David K. Kelley, Thomas C. Keyserling, Maria M. Kolar, James G. Dixon, Sharon X. Xie, Carmen L. Lewis, Bryan A. Bognar, Connie T. DuPre and David R. Coxe, et al.

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Abstract

OBJECTIVE: To evaluate and compare the readiness of academic general internal medicine physicians and academic family medicine physicians to perform and teach 13 common ambulatory procedures.
DESIGN: Mailed survey.
SETTING: Internal medicine and family medicine residency training programs associated with 35 medical schools in 9 eastern states.
PARTICIPANTS: Convenience sample of full-time teaching faculty.
MEASUREMENTS AND MAIN RESULTS: A total of 331 general internists and 271 family physicians returned completed questionnaires, with response rates of 57% and 65%, respectively. Academic generalists ranked most of the ambulatory procedures as important for primary care physicians to perform; however, they infrequently performed or taught many of the procedures. Overall, compared with family physicians, general internists performed and taught fewer procedures, received less training, and were less confident in their ability to teach these procedures. Physicians’ confidence to teach a procedure was strongly associated with training to perform the procedure and performing or precepting a procedure at least 10 times per year.
CONCLUSIONS: Many academic general internists do not perform or precept common adult ambulatory procedures. To ensure that residents have the opportunity to learn routine ambulatory procedures, training programs may need to recruit qualified faculty, train current faculty, or arrange for academic specialists or community physicians to teach these skills.

Key words  academic generalists - ambulatory procedures - residency training - confidence teaching

Presented in part at the 1996 and 1998 meetings of the Society of General Internal Medicine and at the 1998 meetings of the Midwest Society of General Internal Medicine.
This work was supported in part by grant 2D28PE54004 from the Bureau of Health Professions, Health Resources and Services Administration, to the Faculty, Development Program for General Internal Medicine, University of North Carolina at Chapel Hill, and by Grant 52285 from the Summa Health System, Akron, Ohio.

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