Introduction
The Accreditation Council of Graduate Medical Education (ACGME) and American Board of Thoracic Surgery mandate operative proficiency through tabulation of key procedures throughout residency, aimed at ensuring a level of surgical competency prior to graduation 1–3. The impetus being that through familiarization of the cadence of procedures as well as the necessary skill set, the trainee will be able to perform these procedures safely and independently by the end of training. While the operating room (OR) is a controlled environment with faculty supervision, procedures carried out at the bedside can have significantly less oversight 4. These procedures including chest tube placement, central line cannulation have intrinsic risk and can be morbid or mortal if done improperly. However, there are no current number of procedures that a trainee needs to perform and no clear-cut guidelines exist for assessing bedside procedure competency4–7. There is limited instruction from faculty on these procedures, often resulting in instruction from senior residents instead 8,9. While this follows the see one, do one, teach one mantra integral to surgery, it can lead to high variability in procedural competence and no clear delineation of privileges in trainees.
Our institution had no set mechanism for the delineation of bedside procedures for our residents. Given the overall potential for harm and with a directive from the local Graduate Medical Education (GME) office we developed a training and credentialing program for our resident. The course was designed and implemented by a small working group of attending physicians, advanced practice providers (APP) and residents. More so as, integrated teams continue to change the landscape of surgical training, it is important to recognize that other practitioners; nurse practitioners, physician assistants and physicians in other sub-specialties play a critical role in the education and training of residents. This can be especially pointed in the realm of bedside procedures. Thus, in developing the curriculum a multifaceted approach to the curriculum was used. The goal of this study was to evaluate the development and execution of a high-risk bedside procedures credentialing program for trainees by surveying resident on their previous experiences, attitudes and knowledge on each procedure.