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U.VA. School of Nursing Course Teaches Medical Students Basic Clinical Skills

Clinical procedures such as starting an IV, inserting a urinary catheter and obtaining an EKG are often thought of as nursing skills. But what happens if a nurse is not available? Do physicians know how to perform these functions?

Next week, all 135 third-year U.Va. medical students will head to the U.Va. School of Nursing to learn basic clinical skills from veteran nurses, emergency medical technicians and respiratory therapists. In addition, the medical students will shadow an experienced nurse to gain a better understanding of the nursing profession. This unique four-day course, which begins June 22, is designed to provide hands-on instruction of important clinical procedures and promote better collaboration between physicians and nurses.

The course was created in 1990 by Dr. Tina Brashers, a pulmonologist and assistant professor at the School of Nursing. Brashers developed a special interest in skills training for medical students from a situation she encountered shortly after she completed her fellowship and began practicing at a rural family medicine clinic.

One night at 8 p.m., everyone had gone home, and someone came to the clinic door, she said. It was a 14-year-old having an asthma attack. As a pulmonologist, I knew exactly how to calculate the medication to give her, but I suddenly realized I had no clue how to get the medicine into the patient. I had always relied on the nurses to administer my orders for medication.

Although Brashers eventually did administer the medication that day, the experience made her realize that many physicians end up completing medical school and residency without knowing how to perform the basic clinical procedures often handled by nurses. In 1990, she conducted a survey of medical students and faculty, which found that while both groups felt it was important that medical students learn basic nursing skills, there was a lack of competency in medical students performing these skills.

So Brashers approached the School of Medicine faculty about developing a course for both nursing and medical students that would provide hands-on instruction of basic clinical skills. The faculty were so receptive that they made it a requirement of rising third-year medical students.

The course is designed to use integrated education as a way of providing safe basic patient care skills acquisition while promoting future collaborative practice between nurses and physicians, Brashers said. We break up the class into small groups, and the groups rotate through 15 skills stations taught by volunteer health care professionals. The other part of the course is the half-day shadowing program, where the nursing students shadow on-call residents and medical students shadow nurses.

After the course, the students come away with a greater appreciation for each other's profession, Brashers said. The medical students always say, 'I never knew all the things that nurses do.' And they feel freer to ask questions and admit they don't know how to do something. As far as I know, no other medical school/nursing school joint effort offers a class for basic clinical skills on an ongoing basis. Our course appears to be unique, and it succeeds largely because of the willingness of the professional nursing staff to contribute their time and efforts.

For more information, call Dr. Tina Brashers at (804) 924-2027.

June 16, 1999