--- abstract: |- Abstract: Objective: To determine resident comfort and skill in performing ambulatory care skills. Methods: Descriptive survey of common ambulatory care skills administered to internal medicine faculty and residents at one academic medical center. Respondents were asked to rate their ability to perform 12 physical exam skills and 6 procedures, and their comfort in performing 7 types of counseling, and obtaining 6 types of patient history (4 point Likert scale for each). Self-rated ability or comfort was compared by gender, status (year of residency, faculty), and future predicted frequency of use of the skill. Results: Residents reported high ability levels for physical exam skills common to both the ambulatory and hospital setting. Fewer felt able to perform musculoskeletal, neurologic or eye exams easily alone. Procedures generally received low ability ratings. Similarly, residents’ comfort in performing common outpatient counseling was also low. More residents reported feeling very comfortable in obtaining history from patients. We found little variation by gender, year of training, or predicted frequency of use. Conclusion: Self-reported ability and comfort for many common ambulatory care skills is low. Further evaluation of this finding in other training programs is warranted. altloc: - http://www.med-ed-online.org/res00037.htm chapter: ~ commentary: ~ commref: ~ confdates: ~ conference: ~ confloc: ~ contact_email: ~ creators_id: [] creators_name: - family: Bonds given: ' Denise E' honourific: '' lineage: ', MD, MPH' - family: Mychaleckyj given: Josyf C honourific: '' lineage: ', MA, D Phil' - family: Watkins given: Raquel honourific: '' lineage: ', MD' - family: ' Palla' given: Shana honourific: '' lineage: ', MS' - family: Extrom given: Pam honourific: '' lineage: '' date: 2002-10 date_type: published datestamp: 2002-10-18 department: ~ dir: disk0/00/00/25/40 edit_lock_since: ~ edit_lock_until: ~ edit_lock_user: ~ editors_id: [] editors_name: [] eprint_status: archive eprintid: 2540 fileinfo: /style/images/fileicons/application_pdf.png;/2540/1/res00037.pdf full_text_status: public importid: ~ institution: ~ isbn: ~ ispublished: pub issn: ~ item_issues_comment: [] item_issues_count: 0 item_issues_description: [] item_issues_id: [] item_issues_reported_by: [] item_issues_resolved_by: [] item_issues_status: [] item_issues_timestamp: [] item_issues_type: [] keywords: ' medical education; health professional education; peer-reviewed; Clinical science education; Ambulatory education' lastmod: 2011-03-11 08:55:04 latitude: ~ longitude: ~ metadata_visibility: show note: ~ number: 7 pagerange: ~ pubdom: FALSE publication: Medical Education Online publisher: ~ refereed: TRUE referencetext: |2 1. Kimball HR, Petersdorf RG. Back to the future for internal medicine? Am J Med 1998; 104:315-6. 2. Association of American Medical Colleges. AAMC policy on the generalist physician. Acad Med 1993; 68:1-6. 3. American College of Physicians Task Force on Physician Supply. The role of the future general internist defined. Ann Intern Med 1994; 121:616-622. 4. Program Requirements for Residency Education in Internal Medicine: American College Graduate Medical Education, 2001. 5. American Board of Internal Medicine. Policies and Procedures 2000. Vol. 2001, 2000. 6. Wigton RS, Nicolas JA, Blank LL. Procedural skills of the general internist. A survey of 2500 physicians. Ann Intern Med 1989; 111:1023-34. 7. Wickstrom GC, Kelley DK, Keyserling TC, et al. Confidence of academic general internists and family physicians to teach ambulatory procedures. J Gen Intern Med 2000; 15:353-60. 8. Woolliscroft JO, Palchik NS, Dielman TE, Stross JK. Self-evaluation by house officers in a primary care training program. J Med Educ 1985; 60:840-6. 9. Mullen PB, Blitz SG, Stross JK. Faculty expectations and primary care resident's perceptions concerning residents' growth in competence at one medical school. Acad Med 1992; 67:113-117. 10. Venables W, Ripley B. Modern Applied Statistics with S-PLUS. New York: Springer-Verlag, 1999. 11. Mangione S, Nieman L. Cardiac auscultatory skills of internal medicine and family practice trainees: a comparison of diagnostic proficiency. JAMA 1997; 278:717-722. 12. Mangione S, Nieman L. Pulmonary auscultatory skills during training in internal medicine and family practice. Am J Resp Crit Care Med 1999; 159:1119-11124. 13. Guide to Clinical Preventive Services. In: Force USPST, ed. Alexandria, Virginia: International Medical Publishing, 1996. 14. Coodley GO, Elliot DL, Goldberg L. Internal medicine training in ambulatory gynecology. J Gen Intern Med 1992; 7:636-9. 15. Conway T, Hu TC, Mason E, Mueller C. Are primary care residents adequately prepared to care for women of reproductive age? Fam Plann Perspect 1995; 27:66-70. 16. Green LA, Fryer GE, Jr., Yawn BP, Lanier D, Dovey SM. The ecology of medical care revisited. N Engl J Med 2001; 344:2021-5. 17. Care Survey: 1998 Summary. Advance data from vital and health statistics. Hyattsville, Maryland: National Center for Health Statistics, 2000. relation_type: [] relation_uri: [] reportno: ~ rev_number: 12 series: ~ source: ~ status_changed: 2007-09-12 16:45:41 subjects: - meo-peer succeeds: ~ suggestions: ~ sword_depositor: ~ sword_slug: ~ thesistype: ~ title: 'Ambulatory Care Skills: Do Residents Feel Prepared?' type: journale userid: 3283 volume: 7