Frequency and confidence in performing clinical skills among medical interns in Kuwait

Figures & data

Table

Practice points
•Though experienced in simple procedures, interns appear inadequately trained in critical skills.
•Some interns feel confident to perform procedures although not adequately trained.
•Many interns have performed common procedures in Obstetrics & Gynaecology, with no evidence of any gender variation in performance.
•Close monitoring of training is needed and internship and undergraduate curricula may warrant review.

Table 1.  Frequency of performance of selected core clinical skills by internship trainees (n = 91)

	Performed
	Never		One/two times		Over 3 times
Skills	N*	%	n	%	n	%
Generic Clinical Skills
Cardiac defibrillation	51	56.0	28	30.8	9	9.9
Endotracheal intubation	46	50.5	26	28.6	13	14.3
Artificial ventilation	39	42.9	33	36.3	16	17.6
Securing airway	28	30.8	38	41.8	24	26.4
Administering cardio-pulmonary  resuscitation	22	24.2	38	41.8	30	33.0
Insertion of intravenous line	14	15.4	22	24.2	51	56.0
Inserting urethral catheter	12	13.2	23	25.3	54	59.3
Medicine
Pericardiocentesis	74	81.3	10	11.0	4	4.4
Needle aspiration of joints	67	73.6	14	15.4	6	6.6
Insertion of central  venous catheter	54	59.3	17	18.7	14	15.4
Treatment of tension  pneumothorax	53	58.2	25	27.5	12	13.2
Insertion of thoracic drainage	53	58.2	25	27.5	9	9.9
Surgery
Venous cut-down	65	71.4	12	13.2	5	5.5
Operative intubation	39	42.9	25	27.5	24	26.4
Anorectoscopy,  proctoscopy/sigmoidoscopy	31	34.1	34	37.6	23	25.3
Incision and drainage of abscesses	16	17.6	26	28.6	46	50.5
Catheterization	8	8.8	20	22.0	60	65.9
Insertion of Foley's catheter	6	6.6	13	14.3	68	74.7
Investigative procedures
Microscopic examination of  microbiological specimens	52	57.1	17	18.7	18	19.8
Examination of blood film	43	47.3	22	24.2	20	22.0
Urine examination (microscopic/dipstick)	20	22.0	25	27.5	41	45.1
Blood sampling (venepuncture)	10	11.0	31	34.1	47	51.6

*The totals under each category may not add up to 91 as the number of subjects who did not respond is not shown in the table.

Table 2.  Interns’ self-perceived confidence in performing selected clinical skills (n = 91)

	Confident		Concordant Pairs (%)
Clinical skill	N*	%	Confident but never performed n (%)	Performed but not confident n (%)	P value
Inserting intravenous line	65	71.4	1 (1.5)	6 (54.5)	<0.001
Inserting urethral catheter	63	69.2	1 (1.6)	6 (50.0)	<0.001
Nasogastric feeding	58	63.7	3 (5.2)	9 (60.0)	<0.001
Securing airway	50	54.9	1 (2.0)	8 (38.1)	<0.001
Administering CPR	42	46.2	3 (7.1)	20 (60.6)	<0.001
Pleural tap	38	41.8	3 (7.9)	11 (40.7)	<0.001
Artificial ventillation	35	38.5	3 (8.6)	12 (35.3)	<0.001
Entrotracheal intubation	27	29.7	2 (7.4)	13 (32.5)	<0.001
Cardiac defibrillation	23	25.3	4 (17.4)	14 (32.6)	<0.001
Lumbar puncture	23	25.3	3 (13.0)	18 (40.0)	<0.001
Needle aspiration of joints	19	20.9	5 (26.3)	5 (11.1)	<0.001

*The totals under each category may not add up to 91 as the number of subjects who did not respond is not shown in the table.

Table 3.  Interns’ self-perceived confidence in performing clinical skills in Obstetrics & Gynecology: selected skills presented on the basis of gender (M = male, F = female) of trainee (n = 91)

	Confident		Concordant Pairs (%)
			Confident but never performed					Performed but not confident
	M		F		M		F		P value	M		F
Clinical skill	n*	%	n	%	n	%	n	%		n	%	n	%	P value
Repair of episiotomy	40	44.0	36	39.6	0	0	0	0	1	1	2.4	4	10.0	0.148
Conducting normal deliveries	32	35.2	32	35.2	0	0	0	0	1	4	11.1	6	15.8	0.556
High vaginal swab	20	22.0	28	30.8	2	15.4	2	40.0	1	3	14.3	3	10.3	1
Collection of cervical smear	16	17.6	24	26.4	3	21.4	1	14.3	0.232	3	18.8	5	17.9	0.600
Artificial rupture of membranes	16	17.6	19	20.9	3	21.4	1	9	0.260	15	27.8	6	25.0	0.866
Application of fetal electrodes	12	13.2	14	15.4	2	15.4	0	0	0.131	6	37.5	7	33.3	0.910

*The totals under each category may not add up to 91 as the number of subjects who did not respond is not shown in the table.