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Office procedural skills in family medicine.

In a study of 131 residents, 34 faculty members, and 236 graduates at nine family practice residency programs in Iowa, 29 office and outpatient procedural skills (for example, repair of lacerations) were identified as representing the ideal core content for family practice residency training, and another 11 procedures (for example, endometrial biopsy) were identified as elective procedures. The faculty members' responses that residents were taught these 40 procedures by direct supervision were much higher than third-year residents' reports of having been supervised while performing them. There was a positive relationship between the percentage of residents who reported having been supervised and the percentage who felt competent to perform the procedures. There was strong agreement among faculty members, residency graduates, and the residents that residents should be evaluated by direct observation of their performance of both core and noncore procedures. Therefore, the view that evaluation by direct observation would be resisted by residents is not supported by this study. As a result of these findings, the authors encourage programs to establish processes for assessing and documenting residents' performances of office and outpatient procedures.