Manual skills workshops for primary care physicians in Israel

Ori Liran, Omer RoדEnblum, Ilan Yehoshua, Limor Adler

Keywords: manual skills; minor surgical procedures; bppv; dry needling

Background:

Some of the most common complaints addressed by primary care physicians (PCPs) require manual interventions, such as lacerations, abscesses, ingrown toenails, pain and benign paroxysmal positional vertigo (BPPV). Many PCPs do not use these interventions regularly. Lately, performing procedural skills was incorporated and made essential as part of the residency program in family medicine in Israel.

Research questions:

To describe the manual skills workshops program for PCPs, implemented in a large healthcare maintenance organization in Israel and to investigate how many PCPs participated each workshop since the program's inception in 2017 and how many PCPs used the skills they have learned in these workshops.

Method:

This study is an observational study which describes the implementation of a manual skills workshops program in MHS between the years 2017 (when it was first launched) to 2021.

Results:

Dry needling - 217 PCPs participated and performed a total of 17,685 dry-needling procedures. Among the PCPs who participated in the workshops, 95 PCPs (43.8%) practised the learnt skill (the annual average number of procedures was 50.9).
Soft tissue and joints injections workshop - 170 PCPs participated and performed 1807 procedures. 23 PCPs (13.5%) practised the learnt skill. The average annual number of procedures was 16.8 .
BPPV workshops - 285 participants and a sum of 2940 maneuvers performed. 109 (38.2%) PCPs practised the learnt procedure. The average annual number of procedures was 7.5.
Minor surgical procedures workshops - 373 PCPs participated, 5,245 procedures were performed (average annual 14.8 )
Spirometry - 112 participants and a total of 505 spirometry tests being made. A total of 16 (14.3%) PCPs practised spirometry (average annual number of procedures was 6.5).

Conclusions:

Some manual skills such as dry needling, soft tissue injections and Epley maneuver were more likely to be used by participants than other skills such as Spirometry and soft tissue injections.

Points for discussion:

What are the adventages of PCPs performing manual skills? (Continuity of care, empowering the physician)

why do some skills are more implented than others?

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