THE ACQUISITION OF PRACTICAL SKILLS BY US MEDICAL-STUDENTS

Increasing interest in skills training has been prompted by concerns o ver risks posed by new, complex clinical environments and the need for medical students to function effectively in such settings. To gain a better idea of the type of instruction currently provided to U.S. medi cal students, a national survey was conducted in 1991. A survey instru ment was prepared after a literature review on practical skills traini ng. Eleven skill and knowledge areas were selected for analysis; six w ere considered ''basic'' and five ''advanced.'' Mailings were directed to the deans of 126 U.S. medical schools. Based on a 94% response rat e (118/126), the skill and knowledge areas taught most commonly includ ed universal precautions, phlebotomy, intravenous line placement, adva nced cardiac life support, and suturing lacerations. Fifty-one (43%) o f 118 respondents reported that they conducted ''transition courses'' for practical skills training. At most such institutions, basic skills were taught more frequently than advanced skills. Where there was no transition course, formal instruction was provided in standing courses and clerkships. The survey indicates that five skill areas are formal ly taught in the majority of U.S. medical schools. These include unive rsal precautions, phlebotomy, starting intravenous lines, suturing lac erations, and advanced cardiac life support. In most cases, evaluation and certification procedures are infrequent. Further studies are nece ssary to gain a better idea of what practical training should be under gone by all U.S. medical students.