Confidence in performing core clinical skills: preliminary results of a survey of trainees completing internship training in Kuwait

ABSTRACT

Several surveys suggest the underemphasis of the learning of practical skills during internship training. While the proportion of interns that had performed some of the common practical procedures during training appeared inadequate, the interns themselves had rated their development of practical skills as not high. Many interns had also indicated that they felt confident to initiate management of conditions although they were not experienced in those areas. We did not encounter any publications dealing specifically with internship training in the Arabian Gulf region. This study was aimed at determining the confidence of interns in performing core clinical skills. Interns who completed rotations in the major specialties during 2005/06 responded to a questionnaire that listed 48 core clinical skills. Out of the 124 eligible for the study, 85 responded. They indicated their confidence to perform the skills in future and the number of times these had been performed. The majority of the interns felt confident with routine skills, while approximately half felt confident with emergency resuscitation skills. A third of the trainees were confident in performing artificial ventilation and endotracheal intubation. Similarly, a half was confident in performing pericardiocentesis, indirect laryngoscopy, lumbar puncture irrigation of the ear, insertion of thoracic drainage, venous cutdown and insertion of central venous catheter. Only about a third of trainees, with no significant gender variation, felt confident to perform common skills in obstetrics and gynecology. While half the trainees were confident in performing emergency resuscitative measures, many others lacked confidence in doing these skills or clinical skills needed in routine situations. Interns who may not acquire competency in the core skills need to be identified early and corrective measures taken. The findings may have implications in the review of the medical undergraduate curriculum as well as in internship training