Dear Sir In the clinical arena, residents frequently supervise their peers in performing procedures, often prior to being comfortable doing the procedures themselves (Mourad et al. 2010). To help residents acquire skills in the teaching and supervision of procedures, we designed and implemented the Procedural Certification Program at the University of Calgary. Expanding upon the concept of a procedural teaching tree whereby senior residents are trained to teach procedures to junior residents using simulators (Ma et al. 2010), the Procedural Certification Program includes a more structured longitudinal curriculum for the resident teachers. Twelve resident-teachers taught seven procedures to 82 learners in a longitudinal fashion using simulation in 65 training sessions. Procedural skills covered include: lumbar puncture, knee arthrocentesis, intubation, arterial blood gas sampling, cardiac auscultation, and ultrasound-guided central venous catheterization, thoracentesis and paracentesis. Resident-teachers taught a minimum of two sessions supervised by faculty and once deemed competent to teach independently, did so for a minimum of two additional sessions. Sessions were rated out of five by learners and faculty using a 10-item teaching effectiveness assessment tool. Resident-teachers' self-reported comfort in performing and teaching the procedure increased (from 3.64 ±1.21 to 4.80 ± 0.42, p=0.01; from 3.36 ± 1.36 to 4.80 ± 0.42; p= 0.005, respectively). Overall teaching effectiveness rated by learners also increased (from 4.73 ±0.24 to 4.93 ±0.11, p=0.01). Ten of the 11 resident-teachers (91%) reported that the program was valuable for him/her as a proceduralist, while all reported it was valuable for him/her as a teacher. Comments from the resident-teachers included: "Procedural teaching as an [PGY-]2 would be especially valuable as you learn about both the skill and effective teaching strategies ..." and "This was an excellent experience. I learned a lot about procedural teaching, and I think the residents I taught had an enjoyable experience as well". In summary, a longitudinal structured training program such as the Procedural Certification Program is both feasible and well-received. Further, it is associated with improved teaching skills for the resident-teachers and may help prepare them for their supervisory role in performing procedures on the wards.
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