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Electives during medical internship.

OBJECTIVE: The purpose of the study was to find out the reasons for selecting elective rotations during a rotating medical internship. METHODS: One hundred and seventy-eight medical interns in the College of Medicine, King Faisal University, Dammam, Kingdom of Saudi Arabia during the period March 2001 to August 2002 completed a questionnaire for their selection reasons with responses on a scale of 1-5. RESULTS: The study comprised 60% males and 98.3% Saudis. The most frequently chosen electives are dermatology 28.1%, radiology 20.8%, anesthesia 9.6% and otorhinolaryngology (ear, nose and throat [ENT]) 9%. Significantly, more males (89.2%) chose radiology rotation and more females (75%) chose ENT rotation. The leading reasons to choose an elective rotation are: 1. to gain broad medical training and education, 2. to assist in choice of future specialty, and 3. being relevant to future specialty. The mean score for ENT and dermatology is higher than radiology and anesthesia for the response "to participate in medical practice in different institute", while dermatology is higher than anesthesia for the response "to help getting acceptance for job in the same institute", and radiology is higher than ENT and anesthesia for the response "it has infrequent or no night duties". CONCLUSION: The reasons chosen reflect the educational value of the electives and their important role in choosing future career. Dermatology and radiology rotations are most popular electives, with additional though different reasons.

Anesthesia↗

Postgraduate internship in gynecology and obstetrics for physician assistants: a 4-year experience.

Changes in the Hospital Code (405 Regulations) to limit the number of hours worked by residents have been implemented in New York state and may soon become a nation-wide policy. Although their goal is to guarantee quality of patient care and assure education for residents, the limitation of hours worked has increased manpower shortages, some of which could be resolved by using physician assistants with specialty training. To provide this training, a Postgraduate Internship in Gynecology and Obstetrics for Physician Assistants has been developed at the North Central Bronx Hospital and the Montefiore Medical Center. It is the first program of its kind at the postgraduate level to educate physician assistants specifically for practice in obstetrics and gynecology. The program consists of 3 months of didactic lectures to review and update knowledge on topics in medicine, surgery, gynecology, preoperative and postoperative care, cardiac and trauma life support, and critical care, followed by a clinical year similar to that of a rotating physician intern. We believe that such postgraduate educational opportunities in gynecology and obstetrics benefit both the individual physician assistant's growth and development and the level of care delivered, and may be an answer to staffing needs.

Curriculum↗

Expanding undergraduate dietetic education through a health promotion internship program.

The Lifestyle Assistant Program is a health promotion internship offered by the University of Wisconsin-Stevens Point Health Service. Students majoring in health-related disciplines (e.g., dietetics) gain skills in promoting the six dimensions of wellness: social, occupational, spiritual, physical, intellectual, and emotional. Thirteen competencies provide the basis for training Lifestyle Assistants, who develop, market, present, and evaluate wellness sessions for the university and residential communities. Assistants earn academic credit or a wage. Of particular benefit to assistants majoring in dietetics are studying and operating a self-testing physical assessment unit, which approximates body composition, cardiovascular endurance, muscular strength, and flexibility; using a health hazard appraisal; assisting the University's Nutrition Task Force with its education campaign in the campus cafeterias; and presenting programs on popular nutrition topics (e.g., the athlete's diet). Program evaluation reveals that 84% of participants in programs conducted by assistants gained information of personal benefit. The Lifestyle Assistant competencies support The American Dietetic Association Plan IV minimum competencies in such areas as communication and education. The Lifestyle Assistant experience is in accordance with The American Dietetic Association's Dietetic Manpower Study recommendations: to provide student learning experiences in wellness programs and fitness settings.

Dietetics↗

Attitudes and interpersonal skills during pediatric internship.

The initial phases of a program for analyzing interpersonal skills and attitudes and personal adaptation of pediatric interns at a high-pressure tertiary care hospital are described. Interns found internship stressful and less satisfying in many regards than they expected. They were often unable to cope adaptively with the stresses encountered. There were indications of worsening attitudes toward aspects of patient care. However, interns' confidence increased during the year. A videotape vignette test of interpersonal sensitivity showed no change in sensitivity from beginning to end of the year. Videotapes of interns' visits with clinic outpatients made at three points during the year also showed no improvement in interpersonal or communication skills or attention to psychosocial issues. While parents were generally satisfied with the visit, interns lacked skills in some of these areas. None of the data collected, including sex, marital status, and pre-admission rank by the selection committee, predicted end-of-year performance rating by the chief residents. Sex and marital status were also uncorrelated with measured skills and attitudes.

Adaptation, Psychological↗

A prediction of internship performance.

Previous studies of predictors for occupational therapy internship performance were based on the Report of Student Performance, the tool used before 1974 to evaluate students' clinical performance. The instrument was never tested for validity or reliability. No studies for prediction of clinical performance used the present Field Work Performance Report (FWPR), which was tested for validity and reliability before its adoption late in 1973. Thus, new studies using the FWPR were indicated. Grades from 16 selected college courses and the pre-occupational therapy grade-point average were studied to determine significant relationships with the physical disability intership grades of 72 students from Colorado State University. Neurology was significant at the .0004 level. Further study is necessary to confirm the present findings and to determine additional predictors for clinical performance of Colorado State University students.

Adult↗

Pharmacy internship: patient care experience through nursing service.

A pharmacy internship that offers graduated levels of hospital experience, with an emphasis on nursing assistant and medication administration programs, is described. Students work full time in the summer and part time during the academic year in the three-year program. The progression of duties is as follows: nursing assistant; inpatient drug distribution and control; sterile and nonsterile product production; patient education, monitoring and medication history-taking activities; drug information services; and medication administration. Interns are selected by the pharmacy department and trained and supervised by the nursing staff in nursing assistant and medication aide roles. The program provides the pharmacy department with a highly trained corps of interns who understand and appreciate the full range of systems required to deliver patient care and provides interns with patient-oriented work experiences valuable in their future roles as pharmacists.

Education, Pharmacy↗

[Medical care, medical education, and the job market for physicians: internship in Mexico].

This article endeavors to establish a connection between the emergence and development of internship in Mexico and a series of macrosocial changes, including the extension of Government intervention in medical care, the labor market processes that have led to unemployment among physicians, and the responses of the medical education system. The author considers that this comprehensive analysis will be of use in understanding at least in part the complex dynamics of the influence exerted on each other by medical care and medical education, and particularly how changes in conditions on the labor market for physicians have led to the formulation of ideological paradigms of medical practice and to their institutionalization in the programs of study of the medical schools. The study is also important for developed and developing countries with increasing numbers of physicians and which therefore need to understand the possible causes and effects of this trend.

Developing Countries↗

Performance-based pharmacy internship program.

A structured training program based on behavioral objectives was developed for interns in a hospital pharmacy department. In an 831-bed hospital that employs eight pharmacy interns, each for an average of less than or equal to 20 hours per week, a program was developed to ensure (1) that interns have experience working in all service areas and (2) that staff pharmacists are consistent in the tasks they assign to interns. Interns worked with area supervisors and the internship coordinator to develop 23 learning objectives that covered 10 pharmaceutical service areas. A manual listing the objectives is used by interns to document their progress and by pharmacists to ensure uniform experience for all interns. All staff pharmacists work with interns and participate in their evaluations. This program using behavioral objectives provides interns with basic experience in all areas of hospital pharmacy operations.

Competency-Based Education↗

Nursing internships: a tri-state survey and model for evaluation.

Results of a survey of 14 nursing internship programs are presented, and discussed. The results indicate that objective and systematic evaluation of the derived costs and benefits of these programs is often not considered. A methodology is described and suggested as one model for evaluating program effectiveness.

Cost-Benefit Analysis↗

Can the academic background of medical graduates be detected during internship?

Performance ratings were obtained by the clinical supervisors of four graduated classes of McMaster University medical students during internship. The supervisors detected no difference in performance between the graduates who met the "traditional" admissions criteria (both an undergraduate grade point average of 3.1 or greater on a 4-point scale and previous training in biology, general and organic chemistry, and physics) and those who lacked one or both of these prerequisites. These data suggest that medical schools can expand their admissions criteria without fearing that their graduates will perform less well as interns because of a lack of traditional academic preparation for medical school.

Educational Measurement↗

Structured competency-based hospital pharmacy internship program.

A structural competency-based internship program involving terminal behavioral objectives (TBOs) is described. The program is set up for three levels of interns; junior, senior grade B, and senior grade A. Each level has specific learning requirements and a minimum number of experience hours and TBOs to fulfill. Upon completion of the minimum hours for each level, the intern is evaluated by a committee of pharmacists and examined on his attainment of the TBOs. The order followed in the program allows the interns to progressively build a foundation for professional practice by exposing them to all areas of the pharmacy. All level advancements are accompanied by a salary increase. The program provides departmental staff coverage to the hospital all year. The student interns work approximately 40 hr/wk during the summer and 18 hr/wk during the academic year. The TBO-based program allows the students to gain 3300 hours of experience before they are licensed. This program is an essential complement to a student's scholastic work in his professional training as a hospital pharmacist.

Competency-Based Education↗

The nursing research internship program: providing research training in the clinical setting.

Today's changing health care delivery system with its emphasis on restructuring patient care services requires of nursing greater accountability for patient care services and a more careful and systematic examination of patient outcomes. Nursing research can help the profession meet these challenges. The New York City Health & Hospitals Corporation's Nursing Research Internship Program gives nurses an opportunity to become involved in research and serve as research resources to their colleagues. This program offers instruction in research methods, development and conduct of a research project, and participation in ongoing research activities.

Clinical Nursing Research↗

Critical care nurse internships: in theory and practice.

The CCNIP is a 6-month program that provides didactic instruction and supervised clinical experience to graduate nurses desiring critical care staff nurse positions. During rotations through four critical care units, interns are cross-trained to handle a variety of patient care scenarios. Upon completion of the program nurses are required to fulfill an 18-month service commitment to a critical care unit within the institution. During its 6 years of operation the CCNIP has promoted clinical competency and assisted in the recruitment and retention of staff nurses in critical care. Considering these outcomes, other critical care educators and administrators may want to consider implementing nurse internships as an alternative to traditional orientation programs.

Clinical Competence↗

The impact of a rotation in geriatrics during the internship on young doctors.

We initiated a study aimed to evaluate the impact of a rotation in geriatrics during the internship (Preregistration Year-PY). A total of 46 young doctors who completed a month's rotation in geriatrics during the 5 year period 1993-1997 were located and sent a mail questionnaire. It included queries on how they appreciate the contribution of the rotation on their training. A total of 36 doctors (78%) responded, 94% mentioned they learned new skills and ranked them as highly important, and 91% affirmed that the experience in the geriatric ward contributed to a more positive attitude toward elderly patients. A total of 86% stated they would recommend young graduates to elect a geriatric rotation, 56% believe it should be included as an obligatory rotation during the PY. Based on this survey we concluded that a month's rotation in geriatrics is an important contribution to young graduates' medical education before entering practice. In view of the increasing number of elderly patients in most medical fields such experience should be fostered.

Journal Article↗

A senior-year experience similar to an internship.

A senior year experience similar to an internship was initiated in community hospitals. It is designed to shorten the overall length of training and to restore a broad-based clinical experience to the period of "intermediate patient care responsibility" in the training of new physicians. The program provides students with an opportunity to observe and practice in a primary care setting and expands the clinical resources of the medical school. Analysis of the performance of students in the class of 1974 indicates that they perform on a level comparable with first-year house officers. This program provides a general clinical experience for those students who have not yet decided on future training plans or who are going into primary care fields.

Clinical Competence↗