Teaching Invasive Procedures to Medical Students

Abstract

Teaching medical students to perform invasive procedures poses a number of difficult ethical issues. Patients typically want the most experienced clinician to perform the procedure, not a medical student or resident who is doing it for the first time. Students are often caught in the dilemma of wanting to learn the procedures necessary to gain competence in their profession while at the same time fearing that their own lack of expertise may inadvertently harm the patient. The opportunity to perform invasive procedures may occur infrequently, when there is the greatest impact on patient outcomes and the most dire risk of complications. Formal training in these procedures is often lacking in medical student and resident curricula. Educational use of plastic mannequins or computer simulators to teach invasive procedures may be a helpful adjunct but ultimately falls short of the physical reality of an actual human patient.1 The increasing demands placed on attending physicians and senior residents in the current health care environment in many settings strains their ability to spend extra time teaching medical students procedures at the bedside.2 The traditional "See one, do one, teach one" method of teaching invasive procedures to medical students using patients may not be an optimal educational approach.