Documenting procedures and deliveries during family practice residency: a survey of graduates' experiences, preferences, and recommendations.

Table 1 lists some of the reasons cited in the literature for documenting family practice residents’ procedure experiences. Most educators agree that this is an important task, and several systems have been devised to support this activity. Several problems— most notably low resident compliance and high cost— limit the usefulness of the current systems. In the late 1970s, the University of Washington Family Practice Residency Network (UW Network) developed a centralized database to collect procedure and delivery information for family practice residents in Washington State. In the 1980s and 1990s, the UW Network expanded to include four states (Washington, Alaska, Montana, Idaho). Table 2 gives detailed information on each program. As the centralized system grew, it became too cumbersome to administer and was discontinued in the early 1990s. While each individual program continued to track resident procedures, the UW Network residency directors still desired a centralized database to provide comparison data for the programs. A few years ago, one of the UW Network programs in Spokane, Wash, introduced Palm Pilot personal digital assistants (PDAs) at the residency to facilitate collecting and reporting procedure and delivery data. Based on their successful experience, the UW Network decided to deploy Palm Pilot PDAs to all residents in the 16 affiliated programs. The idea was “sold” to the Documenting Procedures and Deliveries During Family Practice Residency: A Survey of Graduates’ Experiences, Preferences, and Recommendations