Basic Procedures

Rationale

For many students, the internal medicine clerkship is where the basic procedural skills required in other clerkships, subinternships, and residencies are learned.

Prerequisites

Knowledge of relevant anatomy and ability to communicate with patients.

Specific Learning Objectives

1. Knowledge: Each student should be able to describe:
   1. key indications, contraindications, risks, and benefits of each of the following basic procedures:
      1. venipuncture.
      2. blood culture.
      3. arterial blood gas.
      4. electrocardiogram.
      5. nasogastric tube.
      6. urethral catheterization.
      7. peripheral intravenous catheter insertion.
      8. throat culture.
      9. PAP smear.
      10. digital rectal examination.
      11. place and interpret a tuberculin skin test (PPD).
   2. alternatives to a given procedure.
   3. what the patient’s experience of the procedure will be.
2. Skills: Each student should be able to:
   1. demonstrate obtaining informed consent, when necessary, for basic procedures, including the explanation of the purpose, possible complications, alternative approaches, and conditions necessary to make the procedure as comfortable, safe, and interpretable as possible.
   2. demonstrate step-by-step performance of basic procedures with technical proficiency.
   3. observe precautions and contraindications for the procedures used.
3. Attitudes: Each student should:
   1. always participate in obtaining informed consent for basic procedures they perform or in which they participate.
   2. explain what the patient’s experience is likely to be in understandable terms.
   3. communicate risks and benefits to patients.
   4. always make efforts to maximize patient comfort during a procedure.