Skip Navigation LinksHome > January 2014 - Volume 89 - Issue 1 > Make Time for Teaching and Learning Procedural Skills
Academic Medicine:
doi: 10.1097/ACM.0000000000000065
Letters to the Editor

Make Time for Teaching and Learning Procedural Skills

Sinha, Yashashwi; Saleh, Mahdi; Weinberg, Daniel

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Fourth-year medical student, School of Medicine, Keele University, Stoke-on-Trent, Staffordshire, United Kingdom; v0y61@students.keele.ac.uk.

Fourth-year medical student, School of Medicine, Keele University, Stoke-on-Trent, Staffordshire, United Kingdom.

Fourth-year medical student, School of Medicine, Keele University, Stoke-on-Trent, Staffordshire, United Kingdom.

Disclosures: None reported.

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To the Editor:

We read the article by Dehmer et al1 with great interest, as it highlights important opinions of medical students regarding procedural skills competency in the United States. In the United Kingdom, competency with procedural skills can also vary greatly and can leave students unprepared for their hands-on roles as newly qualified doctors. Medical graduates in the United Kingdom are expected to be proficient in a similar set of skills as those required in the United States. Junior doctors have traditionally provided instruction and supervision for students learning procedural skills, but current duty hours restrictions in the United Kingdom and the United States limit junior doctors’ availability to observe and offer feedback. Based on our experience as senior medical students at a modern medical school in the United Kingdom, we suggest ways for students to seek and receive the valuable feedback provided by junior doctors, even in an era of restricted duty hours.

Newly qualified doctors can be more approachable than senior doctors, and they can have a practical and unique perspective on how students learn.2 However, one of the more significant restrictions faced by newly qualified doctors teaching students in the United Kingdom is the European Work Directive (2009), which limits junior doctors to an average of a 48-hour workweek.3 With limited time on the wards, junior doctors in the United Kingdom find less time to teach medical students. Therefore, students should actively seek to be supervised by junior doctors while performing procedural skills, such as venipuncture, intravenous cannulation, and arterial blood gases. Instead of searching for a junior doctor with a bit of free time at the last minute, students can ensure supervision by approaching junior doctors in advance to organize direct observation of procedural tasks.

In spite of duty hours restrictions, there must be a shift to increase the time spent on teaching by newly qualified doctors, alongside teaching by more senior doctors. At our institution and at others in the United Kingdom, skill logbooks provide a semiformal method of assessment to garner and reinforce student learning. Logbooks require students to obtain signatures to verify they have independently performed practical procedures under direct observation. Planning ahead for observation of procedural tasks coupled with the use of skill logbooks with assessment completed by newly qualified doctors may increase students’ confidence and contribute to reaching desired competency levels in basic procedural skills.

Yashashwi Sinha

Fourth-year medical student, School of Medicine,

Keele University, Stoke-on-Trent, Staffordshire,

United Kingdom; v0y61@students.keele.ac.uk.

Mahdi Saleh

Fourth-year medical student, School of Medicine,

Keele University, Stoke-on-Trent, Staffordshire,

United Kingdom.

Daniel Weinberg

Fourth-year medical student, School of Medicine,

Keele University, Stoke-on-Trent, Staffordshire,

United Kingdom.

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References

1. Dehmer JJ, Amos KD, Farrell TM, Meyer AA, Newton WP, Meyers MO. Competence and confidence with basic procedural skills: The experience and opinions of fourth-year medical students at a single institution. Acad Med. 2013;88:682–687

2. Qureshi Z, Seah M, Ross M, Maxwell S. Centrally organised bedside teaching led by junior doctors. Clin Teach. 2013;10:141–145

3. BMA. . European Working Time Directive. 2011 http://bma.org.uk/practical-support-at-work/ewtd. Accessed September 20, 2013

© 2014 by the Association of American Medical Colleges

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