Development of a Chief Resident Medical Procedure Service: a 10-Year Experience.

Autor: Nathanson R; Medicine Service, South Texas Veterans Health Care System, San Antonio, TX, USA. nathansonr3@uthscsa.edu.; Division of Hospital Medicine, Department of Medicine, University of Texas Health San Antonio, San Antonio, TX, USA. nathansonr3@uthscsa.edu., Baher H; Department of Medicine, University of Texas Health San Antonio, San Antonio, TX, USA., Phillips J; Division of Cardiology, University of Texas Health San Antonio, San Antonio, TX, USA., Freeman M; Medicine Service, South Texas Veterans Health Care System, San Antonio, TX, USA.; Division of Hospital Medicine, Department of Medicine, University of Texas Health San Antonio, San Antonio, TX, USA., Sehgal R; Medicine Service, South Texas Veterans Health Care System, San Antonio, TX, USA.; Division of Hospital Medicine, Department of Medicine, University of Texas Health San Antonio, San Antonio, TX, USA., O'Rorke J; Medicine Service, South Texas Veterans Health Care System, San Antonio, TX, USA.; Division of General Internal Medicine, University of Texas Health San Antonio, San Antonio, TX, USA., Soni NJ; Medicine Service, South Texas Veterans Health Care System, San Antonio, TX, USA.; Division of Hospital Medicine, Department of Medicine, University of Texas Health San Antonio, San Antonio, TX, USA.; Division of Pulmonary Diseases & Critical Care Medicine, University of Texas Health San Antonio, San Antonio, TX, USA.
Jazyk: angličtina
Zdroj: Journal of general internal medicine [J Gen Intern Med] 2023 Oct; Vol. 38 (13), pp. 3077-3081. Date of Electronic Publication: 2023 May 26.
DOI: 10.1007/s11606-023-08234-z
Abstrakt: Background: Lack of experienced faculty to supervise internal medicine (IM) residents is a significant barrier to establishing a medical procedure service (MPS).
Aim: Describe the development and 10-year outcomes of an MPS led by IM chief residents.
Setting: University-based IM residency program affiliated with a county and Veterans Affairs hospital.
Participants: Categorical IM interns (n=320) and 4 th -year IM chief residents (n=48) from 2011 to 2022.
Program Description: The MPS operated on weekdays, 8 am-5 pm. After training and sign-off by the MPS director, chief residents trained and supervised interns in ultrasound-guided procedures during a 4-week rotation.
Program Evaluation: From 2011 to 2022, our MPS received 5967 consults and 4465 (75%) procedures were attempted. Overall procedure success, complication, and major complication rates were 94%, 2.6%, and 0.6%, respectively. Success and complication rates for paracentesis (n=2285) were 99% and 1.1%, respectively; 99% and 4.2% for thoracentesis (n=1167); 76% and 4.5% for lumbar puncture (n=883); 83% and 1.2% for knee arthrocentesis (n=85); and 76% and 0% for central venous catheterization (n=45). The rotation was rated 4.6 out of 5 for overall learning quality.
Discussion: A chief resident-led MPS is a practical and safe approach for IM residency programs to establish an MPS when experienced attending physicians are unavailable.
(© 2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)
Databáze: MEDLINE
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