Competence in performing emergency skills: How good do doctors really think they are?

• Published in: African Journal of Emergency Medicine Vol. 7; no. 4; pp. 151 - 156
• Main Authors: Dufourq, Nicholas, Nicole Goldstein, Lara, Botha, Martin
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.12.2017; African Federation for Emergency Medicine; Elsevier
• Subjects: Clinical competence; Competence; Education; Emergency skills; Original; Clinical competence; Emergency skills; Competence; Education
• ISSN: 2211-419X; 2211-4203
• DOI: 10.1016/j.afjem.2017.05.011

Despite the differences in exposure and experience in dealing with medical emergencies, all doctors should nevertheless be competent to assist a patient in need of resuscitation. The objective of this study was to describe the level of self-assessed emergency skill competence that specialist trainees in various disciplines possessed as well as to identify factors that may have contributed to their level of self-perceived competence. A prospective, cross-sectional, questionnaire study of various specialist trainees’ self-perceived levels of competence in emergency skills was conducted across three academic hospitals in Johannesburg, South Africa. Trainees from General Surgery and Internal Medicine (Clinical) and Psychiatry and Radiology (Non-Clinical) rated their self-perceived level of competence in a list of basic, intermediate and advanced emergency skills according to a five-point Likert ranking scale. Ninety-four specialist trainees participated in the study – a response rate of 36%. The overall median competence rating for cardiac arrest resuscitation was 3.0 [IQR 3.0, 4.0] (i.e. intermediate). The median competence rating for cardiac arrest resuscitation in the clinical group (4.0) [IQR 3.0, 4.0] was higher than in the non-clinical group (3.0) [IQR 2.0, 3.0] (p<0.001). Current or expired certification in Paediatric Advanced Life Support (PALS) or Advanced Paediatric Life Support (APLS) courses increased perceived competence and delays in starting specialisation resulted in a decrease in overall competence composite scores for each year of delay after internship. General Surgery and Internal Medicine trainees had a higher level of self-perceived competence in various emergency skills than their non- clinical counterparts. Current certification in advanced life support courses had a positive impact on trainees’ self- perceived levels of competence in emergency skills. Specialist trainees who had less delay before starting their specialist training also demonstrated higher levels of perceived competence.