Procedural Confidence and Teaching Satisfaction Among Internal Medicine Trainees in Relation to Curriculum Requirements

Objectives: This study aimed to describe self-reported confidence in 12 clinical procedures specified in the Joint Royal Colleges of Physicians Training Board (JRCPTB) curriculum and satisfaction with procedural teaching among doctors undertaking Internal Medicine Training (IMT).Secondary objectives were to explore differences between training grades and interpret the findings in relation to curriculum requirements.Methods: A voluntary, anonymised, cross-sectional survey was distributed to IMT1-IMT3 doctors at University Hospital Coventry, University Hospitals Coventry and Warwickshire NHS Trust (UHCW), between June and July 2024.The 28-item questionnaire assessed confidence and teaching satisfaction for 12 procedures.Confidence categories were anchored to self-assessed procedural capability and supervision requirements.Responses were summarised descriptively and compared with the 2023 IMT Annual Review of Competence Progression decision aid.Results: Fifteen trainees completed the survey: 9 IMT1 (60%), 4 IMT2 (27%), and 2 IMT3 (13%).The recruitment denominator was unavailable, so the response rate could not be calculated.Very or extremely confident responses were most frequent for nasogastric tube insertion, 13 (87%); advanced cardiopulmonary resuscitation, 12 (80%); and lumbar puncture, 8 (53%).Ten trainees (67%) reported being not so or not at all confident in diagnostic pleural aspiration, including both IMT3 respondents, 2 (100% of IMT3 respondents).Six trainees (40%) reported these responses for direct current cardioversion.Confidence in vascular access and intercostal drain insertion was also low.Comparisons across grades were exploratory, and the confidence and teaching satisfaction distributions differed for some procedures.Conclusions: Confidence varied substantially between procedures, with diagnostic pleural aspiration and cardioversion warranting further exploration.Protected procedural attachments, access to trained ultrasound practitioners, and supervised cardioversion lists are proposed for local evaluation.This small, single-centre survey cannot establish competence or explain differences in confidence; assessment of exposure and observed performance is needed.