1562: Designing and Implementing a Skills Curriculum Blueprint for Internal Medicine Residents

Introduction: Internal medicine residents at community-based programs cover the intensive care units overnight. Despite the demand for urgent procedures, there was no structure or educational curriculum in place to prepare the internal medicine residents. In response, we created a chief run, interdisciplinary, skills lab procedure curriculum. Taught by varying clinicians, the sessions included landmark identification with ultrasound, sterile and semi-sterile technique with gown and gloves, peripheral IV insertion technique, arterial line review, suture practice, and central line placement with mannequin. Methods: Operating room surgical technician specialist, intensive care unit registered nurses, chief residents, and 3 internal medicine attending physicians created the multidisciplinary education team. Using step-by-step guides, we required the residents to review skill sheets prior to each session. Curriculum design included hands-on skill sessions that varied from 1 session per month to 4 sessions per month. The sessions were variable in that some sessions were based on 25-minute block rotations, see one, do one with selective clinicians, and drop-in sessions. Results: Building procedure checklists standardized competency targets through repetition enabling instructors to provide real-time feedback. And while we focused on curriculum design and implementation, these checklists could certainly aid in testing and performance tracking. Developing signoff sheets that include both the clinician signature and the resident’s signatures enabled a system of shared and combined accountability while promoting professional development. This skills lab curriculum enables rising internal medicine residents to foster their skill set as they grow toward independence. Conclusions: By having a chief resident develop the blueprint and schedule the curriculum sessions allowed us to overcome scheduling barriers around already established lecture-based education. Our unique multiprofessional curriculum shapes the sessions to the overall need of the residency program and institution to provide safe and effective care for its patients. Overall, this outlines the beginnings of a skills lab blueprint for successful implementation of procedural skills through checklists and sign offs for internal medicine residents.