Procedures in primary care are a common and enjoyable aspect of a busy primary care practice. In Family Medicine residencies, we teach everything from minor skin procedures to colposcopy to ultrasound to vasectomy. Learning curves for procedures are steep and some suggest a step-wise approach to teaching procedures including both testing, simulation and maintenance phases. In our Faculty Development Fellowship, we advise educators to use either George et al.’s “Five Instructional Phases” or Sawyer et al.’s “Learn, See, Practice, Prove, Do, Maintain” framework. Both are based on adult learning theories for learning technical skills and involve at least one step in which learners must review material prior to performing the procedure.

In the past, most learners would review a textbook of procedures such as the excellent text by Pfenninger et al., but in today’s world of online learning and medical apps there are now many options. Both George and Sawyer recommend review of instructional videos for example to ensure learners know “what right looks like”. Here on iMedicalApps we previously reviewed regional anesthesia and injection apps such as ASRA Coags Regional, Regional Anesthesia Assistant, Block Buddy, Art of Injection and MSK Injections. For primary care providers, we have reviewed the excellent Procedures Consult (now available as part of Elsevier’s Clinical Key), OMT apps such as DO OMT, CRTech OMT, ultrasound apps for EM, and physical exam apps such as CORE and mskNAV.

Some of the above medical apps are free, but many are either expensive or require institutional subscriptions. I recently met an app developer from Canada at a medical conference named Dr. Jeremy Rezmovitz. He encouraged me to take a look at his free app for family physicians called Proceducate. The medical app is part of a pilot study to improve minor procedural skills of family physicians and is IRB approved by the University of Toronto. The Proceducate medical app focuses on modules to improve suturing, knot tying and minor procedures such as joint aspiration/injection, biopsy, toenail removal, and gyn procedures such as IUD insertion and perineal laceration repair. Each section includes high quality videos as well as didactic information on the indications, contraindications, etc. of each procedure.

Clinical Scenario

You are scheduled to precept an intern in minor procedures clinic tomorrow. You notice that the intern has several skin biopsies, a toenail removal and an IUD insertion on the schedule. The intern states she has done some biopsies, but isn’t confident about her suturing skills and has never performed an IUD insertion or toenail removal previously but saw them in medical school. How could you use Proceducate to enhance both her knowledge and confidence prior to procedure clinic tomorrow? Let’s take a look at Proceducate in action.

Video Review of Proceducate Medical app:

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Evidence based medicine

The app includes numerous quality images, still animation, and recorded videos of common primary care procedures. Although the app itself has not been proven superior to other traditional (textbook) based approaches, it is part of an IRB approved study and follows current best practices in the literature recommending the use of multimedia in teaching technical skills such as procedures.

What providers would benefit from the Proceducate Medical App?

Family Medicine faculty, residents, medical students, mid-levels and any provider who may be required to perform the procedures covered in the app.

procedurate app review

Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government.

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