Teaching procedural skills to medical students: One institution's experience with an emergency procedures course

Study objective: We examine the effect of a preclinical emergency procedures course on students' clinical procedural skills and medical knowledge. Methods: This is a retrospective review of evaluation forms for a cohort of 86 students graduating from medical school at an academic center. A cross section of students (n=57) taking a clinical emergency medicine rotation over a 4-year period was also studied. Numeric scores (1 to 9 on a Likert scale) in procedural skills and medical knowledge categories were extracted from evaluations for internal medicine, surgery, obstetrics and gynecology, and emergency medicine rotations. Scores of students who had taken an elective course, Essential Procedures in Emergency Medicine (EPEM), were compared with scores of students who did not take this course. US Medical Licensing Examination Step I scores for both groups were also compared. Results: Students who took EPEM scored significantly higher in the procedural skills category during the emergency medicine rotation (P=.04) and during both months of the internal medicine rotation (P=.02; P=.02). Students scored on average higher in the surgery and obstetrics and gynecology rotations, but these differences were not statistically significant. Students who took EPEM scored significantly higher in the medical knowledge category for emergency medicine (P=.01; P=.002), both months of internal medicine (P=.03; P=.006), and 1 of 2 months of surgery (P=.01) rotations. Students in obstetrics and gynecology rotations scored higher, although not significantly. US Medical Licensing Examination Step I scores were not different between students taking or not taking EPEM. Conclusion: Students taking EPEM achieved higher procedural skill and medical knowledge scores in clinical rotations. Emergency medicine is a specialty well suited to study procedures teaching and performance.