Teaching medical procedures to interns and residents

The traditional method of learning medical procedures may need to be revamped.

Procedures, like inserting a central line, can be technically difficult and fraught with complications. The traditional way of teaching was to do one, have a medical resident watch, and then supervise the physician-in-training’s first attempt. Today’s focus on patient safety doesn’t lend itself to medical trainees practicing on live patients.

Indeed, the teaching aspect is lost in many cases, with this anesthesiologist giving an example where “the first time an attending did a central line in front of me I asked her to talk through what she was doing so I could learn from her technique. She couldn’t be bothered.”

Ideally, training of medical procedures should be formally taught, then practiced on models, before attempts on live patients. However, residencies are strapped for resources, and there is even less time for didactic sessions with the tightening of work-hour restrictions.

The axiom of “see one, do one, teach one,” may not be enough anymore, and instead “it takes respect for the act of teaching itself, and patience for each person’s learning process, and ultimately a love of medicine and patient, in order to achieve real, fruitful education.”

It’s important advice for every teaching attending.

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