Training Using Simulation in Internal Medicine Residencies: An Educational Perspective

• Published in: The American journal of the medical sciences 2015-03, Vol.349 (3), p.276-278
• Main Authors: Flannery, Michael T., MD, Villarreal, Kara F., AA, Wong, Jeffrey G., MD, FACP
• Format: Article
• Language: English
• Subjects: ABIM; ACGME; GME; Internal Medicine; Internal Medicine - education; Internship and Residency; Medical procedures; Milestones; NAS; Professional Competence; Simulation
• ISSN: 0002-9629; 1538-2990
• DOI: 10.1097/MAJ.0000000000000406

Abstract Background The American Board of Internal Medicine has defined through the min-CEX (Clinical Examination booklet) that a resident would need to perform anywhere from 3 to 5 procedures to be competent in a given procedure. Many faculty and residents believe that this number is too low to achieve competency. Methods Although simulation has been required as part of medical training, we have reviewed a number of articles addressing competence and potentially fewer complications with improved patient safety. Results The Accreditation Council for Graduate Medical Education has simply stated that simulation should be part of residency training. However, this has resulted in a disorganized approach among the nearly 385 internal medicine programs in the United States. Conclusions This article suggests a model of simulation that addresses procedures, medical codes and major medical problems that each resident achieve competence in before graduating residency. This would require minimally a doubling of the number of procedures to define competency and will do so in a far more scientific method.