A Skills‐Based Curriculum for Outpatient Procedures in Internal Medicine Residency Training: Impact on Resident Confidence and Procedural Volume

BACKGROUND: Outpatient procedures are an important part of primary care practice; however, few trainees or attendings feel they have adequate skills to perform them. This curricular intervention aimed to improve internal medicine (IM) Post-Graduate Year 1 (PGY1) outpatient procedure training through a 2-h skills session and procedure rotation. APPROACH: Thirty-seven PGY1 residents attended a 2-h skills session covering the utility and evidence behind common outpatient procedures with an opportunity to practice procedures on models. Residents already assigned to one continuity clinic rotated through a specific procedure clinic while the other continuity clinics received the standard curriculum. The skills session and procedure clinic were started in 2023 and evaluated during 2024-2025 academic year. EVALUATION: Residents were surveyed prior to the skills session and at the end of their PGY1 year. The primary outcomes measured were self-reported procedure volume and confidence. The two-tailed Mann-Whitney U test was used to compare differences between groups. Residents completing the procedure clinic rotation demonstrated higher confidence scores for performing procedures (median 4 [IQR 0] vs. 2 [IQR 2.5] on 5-point Likert scale, p = 0.009) and discussing procedures with patients (median 4 [IQR 1] vs. 3 [IQR 2], p = 0.027). Residents completing the rotation also reported performing significantly more procedures during their PGY1 year (median 5 [IQR 2] vs. 1 [IQR 2], p = 0.001). IMPLICATIONS: A hands-on skills session followed by procedure clinic rotation was associated with higher PGY1 confidence in discussing and performing outpatient procedures. The curriculum was integrated into existing residency program infrastructure and continuity clinic rotation.