Procedures Logbook for Internal Medicine Residents
BackIntroduction
To meet the requirements for ABIM Certification and be able to obtain hospital clinical privileges, you will need to verify and document your competency regarding the following: (1) understanding the indications, limitations, contraindications and complications of diagnostic and therapeutic procedures, (2) how to perform these procedures, (3) how to interpret their results. This logbook was designed to help you verify and document your knowledge and competence in the performance and mastery of certain procedures during residency training.
The logbook format provides a convenient record for verifying your procedural skills and is designed to function as a concise, convenient record of your procedural performance throughout training.
TopHow to Use the Logbook?
To use the logbook fill in the type of procedure performed, date, patient name, and/or medical record number. Substantiation of your clinical competence in performing procedures is the responsibility of the supervisor (qualified physician) who observes you, evaluates your cognitive and technical abilities, signs the logbook, and indicates whether any improvements in your skills are needed.
Qualified physician is defined as the individual who is competent to perform as well as authorized to teach the procedure. Ultimately this individual should attest to your competence to conduct the procedure independently.
Cognitive skill is defined as your competency in understanding the indications, limitations, contraindications and complications of the designated procedure and interpreting the results.
Technical skill is defined as your competency in performing the procedure.
TopProcedures Required for Certification in Internal Medicine
Safety is the highest priority when performing any procedure on a patient. ABIM recognizes that there is variability in the types and numbers of procedures performed by internists in practice. Internists who perform any procedure must obtain the appropriate training to safely and competently perform that procedure. It is also expected that the internist be thoroughly evaluated and credentialed as competent in performing a procedure before he or she can perform a procedure unsupervised.
For Certification in internal medicine, ABIM has identified a limited set of procedures for which it expects all candidates to be competent with regard to their knowledge and understanding. This includes (1) demonstration of competence in medical knowledge relevant to procedures through the candidate's ability to explain indications, contraindications, patient preparation methods, sterile techniques, pain management, proper techniques for handling specimens and fluids obtained, and test results (2) ability to recognize and manage complications and (3) ability to clearly explain to a patient all facets of the procedure necessary to obtain informed consent.
For a subset of procedures, ABIM requires all candidates to demonstrate competence and safe performance by means of evaluations performed during residency training. The set of procedures and associated competencies required for each are listed below.
To help residents acquire both knowledge and performance competence, ABIM believes that residents should be active participants in performing procedures. Active participation is defined as serving as the primary operator or assisting another primary operator. ABIM encourages program directors to provide each resident with sufficient opportunity to be observed as an active participant in the performance of required procedures. In addition, ABIM strongly recommends that procedural training be conducted initially through simulations. At the end of training, as part of the evaluation required for admission to the Certification Examination in Internal Medicine, program directors must attest to each resident's knowledge and competency to perform the procedures. ABIM does not specify a minimum number of procedures to demonstrate competency; however, to assure adequate knowledge and understanding of the common procedures in internal medicine, each resident should be an active participant for each procedure five or more times.
TopOther Procedures
Residents can benefit from the opportunity to achieve competence in additional procedures that may be required in future practice settings. These may include arterial line placement, cryosurgical removal of skin lesions, elective cardioversion, endotracheal intubation, skin biopsies, soft tissue and joint injection, temporary pacemaker placement, treadmill exercise testing, and interpretive skill in ambulatory electrocardiography, ambulatory blood pressure monitoring, chest roentgenograms, and spirometry.
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