Procedural skills

Contents

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Procedural skills are more important than ever for practicing physicians. The clinician's skill and judgment in doing a procedure affect patient safety and comfort as well as the quality of the diagnostic samples. With managed care, generalists anticipate doing more procedures rather than fewer. At the same time, accountability is increasing, focusing more attention on credentialling and monitoring of outcomes. The seven procedures on this CD-ROM are those required by the American Board of Internal Medicine as essential to the practice of Internal Medicine. These are the basic procedures for obtaining body fluids for diagnosis and for access for medication and drainage. This CD-ROM is part of an integrated multimedia learning tool. It uses video movies, sound, color illustrations, and text to present techniques and in-depth information about the seven procedures. Training in the technical and cognitive aspects of procedures is not always available when you need it, and knowledge about indications, complications, and interpretation of results is critical to expert and safe performance. For these reasons, we have made the program both flexible and comprehensive, allowing you to use the program for in-depth study or quick review. The accompanying Reference Manual covers much the same material, but more concisely. Use the Manual for a quick review and a place to keep notes. Use the videos and the CD-ROM text and cases for in-depth learning and review of techniques. The best way to learn how to do procedures is to observe them being done. We have included over 40 video clips, showing how to do the procedures using different techniques. Hypertext links let you explore each topic in more depth. You can print out items for your own use such as information sheets for patients and nursing staff, patient consent forms, lists of equipment needed, differential diagnoses, and tests commonly ordered. You can modify these forms to fit your needs before printing. For review, check out the quizzes and the clinical case vignettes that are coordinated by section to cover the same material in case example form. A project of this size and complexity could not have come together without the contributions and creative energies of many people. Stephanie Manning is the editor at Mosby whose vision and encouragement made this project happen. We are indebted to all of the staff at the Section of General Medicine at the University of Nebraska Medical Center. In particular, we are indebted to our project coordinator, Wayne Manke, who miraculously kept all of the myriad pieces of the puzzle together and kept us on track. We are grateful to our medical illustrator, Mary Jean McFadden, for her hard work and patient understanding. Thanks go to Kristin Perry and Markey Drake for their many contributions, and to Kathy McCormack and Shirley Yeich for their secretarial help. We are indebted to the residents and faculty at the University of Nebraska Medical Center who contributed to the video recordings: Drs. Leanna Scott Timperley, James Edney, Nancy Davis, Kristen Fulton, Clinton White, Rifaat Bashir, James Chapin, Barbara Hurlbert, Suzanna VonEssen, Joseph Sisson, and Donald Bennett. We could not have made the videos without the contributions of Mary Williamsen, with her directing, editing, and camera work--at all hours. We are grateful to the staff at Mosby-Year Book who patiently saw us through the deadlines and polished the rough manuscripts. We thank Laura Berendson for her editorial and organizational skills, Elaine Steinborn for her superb writing skills in crafting the Reference Manual, and Anne Patterson for her support and encouragement. The CD-ROM production is the result of many creative talents at Hands-On Interactive in St. Louis: Chris Ruess, Bill Haines, Kelly Ogonoski, Lance Reidel, Eelin Toh and John Viviano. This was an exciting adventure that gave us a glimpse of the great potential of these new media for medical education. We thank all of those colleagues, family, and friends who patiently stood by us as we explored these new directions. Robert S. Wigton, M.D., M.S. Thomas G. Tape, M.D.

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