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[Self-assessment of clinical skills among medical trainees when entering internship during the spring seasons 1998].

The aim of this study is to identify medical trainees' level of self-reported clinical skills when entering internship. A questionnaire was sent to 124 trainees, who were about to enter their internship. The questionnaire included 88 questions on clinical skills, asking the trainees to rate their level of mastership on a Visual Analogue Scale from zero to ten, 0 = not mastering and 10 = mastering. In total one hundred (81%) returned the questionnaire. There is considerable variation in the self reported acquisition of clinical skills in many of the procedures. In some basic procedures most trainees showed a rather high level of mastership, above 7.5, but in other basic procedures about half of the candidates report a level of mastership below 5.0. A more thorough specification of objectives for practical skills would make it easier to plan an effective and efficient training during internship.

Adult↗

Attitudes of physical therapist students toward physical therapist assistants before and after full-time clinical internships.

Development of attitudes of physical therapists (PTs) toward physical therapist assistants (PTAs) begins during their professional education, and attitudes are influenced further by clinical experiences. The purpose of this study was to understand attitudes of student PTs toward PTAs. We surveyed 66 clinical intern students enrolled in an entry-level master of physical therapy program. PT students received the same survey before and after their full-time clinical internship. Eleven Likert scale items were used to assess students' attitudes toward PTAs in the areas of competence, financial remuneration, and job security. One item was designed to determine whether PT students' level of contact with PTAs influenced attitudes. A random sample of 13 (20.9%) students who returned surveys were asked to participate in a telephone interview designed to enrich the quantitative data. After item analysis, five of the scale items were eliminated from the analyses due to poor internal consistency. Cronbach's alpha of the remaining six scale items was 0.75. Survey results reveal that PT students maintain an overall positive attitude toward PTAs before and after full-time clinical internship. Qualitative interview data support this finding. Students' attitudes in specific areas of PTA competence were negative and positive, however. The negative attitude may have been based on the students' beliefs that PTAs are not competent to perform physical therapy in situations that are changing or unpredictable. Positive attitudes may have been reflective of the students' beliefs that PTAs are competent to implement established plans of care. Student ranking of four professional issues showed a significant difference before and after full-time clinical internships.

Adult↗

Effects of residency training in family medicine v. internship training on professional attitudes and practice patterns.

OBJECTIVES: To determine whether the professional attitudes and practice patterns of physicians with residency training in family medicine differ from those of generalists with internship training. DESIGN: Mail survey conducted in 1985-86. SETTING: Province of Quebec. PARTICIPANTS: A stratified random sample of French-speaking family and general practitioners who graduated after 1972 (325 physicians with residency training and 304 with internship training) (response rate 82%). MAIN RESULTS: Physicians with residency training were 3 years younger on average than those with internship training, were more likely to be female (38% v. 18%, p less than 0.001) and were more likely to work on a salaried basis in CLSCs (public community health centres) (36% v. 14%, p less than 0.001). Even after these confounding factors were controlled for, physicians with residency training seemed to be more sensitive to the psychosocial aspects of patient care and tended to attach more importance to informing patients about useful materials and resources concerning their health problems. They were not, however, more likely to value health counselling or integrate it in medical practice. CONCLUSION: Our findings provide some evidence that the new requirement that physicians complete a residency in family medicine to obtain medical licensure in general practice in Quebec may foster a more patient-centred approach to health care.

Adult↗

Evaluation of a predoctoral clinical psychology internship program by intern graduates.

This investigation is a replication and extension of an earlier study by Stout, Holmes, and Rothstein (1977) of the predoctoral clinical psychology intern graduates at the William S. Hall Psychiatric Institute. The interns were surveyed (N = 63) with regard to how adequately their internship experience prepared them for their current professional work as practicing clinical psychologists. Questionnaire data (n = 44) from graduates are analyzed in terms of the demographics of each intern's work situation, ratings of how well their internship prepared them in the areas of interprofessional relationships, teaching psychodiagnostic evaluations, psychological treatment, administration, consultation, and research. Several recommendations are offered by the intern graduates for refinement of the clinical psychology internship.

Adult↗

Assessment of student selection practices and beliefs in dietetic internship programs.

With declining college enrollment, the health professions, including dietetics, are recognizing a need to assess and monitor student selection more closely. In this survey of 102 dietetic internship programs, program directors and a sample of their faculty members were asked to describe their current selection practices and to identify the beliefs they hold about the information obtained from various components of their procedures. Differences in beliefs between program directors and other faculty members were compared by t-test analysis. The five major categories of internship selection procedures are presented with information items faculty members believe are derived from each category, and the results are compared with those of previous surveys of dietetic selection practices. Major findings are that the intern selection process has changed significantly since 1978, with greater emphasis on work experience and extracurricular activities; the number of applicants per position has doubled despite a doubling of dietetic internship programs; and program directors and faculty members agree on the major selection practices but not on the information obtained from a given category. In the discussion, the findings are evaluated against a broad background of health profession education literature; implications are raised for intern selection committees and for the applicant.

Dietetics↗

Pediatric/neonatal graduate nurse internship: a collaborative effort.

An internship was developed as a single unit program to prepare graduate nurses to function competently and confidently in the Pediatric Intensive Care Unit (PICU). An analysis of resources, common goals, and philosophies subsequently led to the development of a collaborative internship program between the Pediatric and Neonatal Intensive Care Units. This innovative approach enhanced the internship program and met the mutual goals of each nursing unit.

Child↗

Graduates of internships and coordinated undergraduate programs--do differences exist?

Two principal routes have existed for several years for gaining credentials for dietetic practice, the dietetic internship and the coordinated program. However, comparative evaluations of the effectiveness of these programs in preparing entry-level practitioners have been limited. In this study, adequacy of educational preparation and performance of dietetic internship and coordinated program graduates was assessed at entry level and after one year of practice, using graduates' self-ratings and supervisors' evaluations. The majority of graduates who were employed in dietetic practice held clinical positions in hospitals or university medical centers. Educational preparation and level of performance of all graduates were considered to be adequate, indicating that both types of programs are preparing knowledgeable and competent entry-level practitioners. Although differences on competency measures were not reflected at entry level, intern graduates scored significantly higher than graduates of coordinated programs on administrative and clinical competencies after one year of practice. Also, at entry level and after one year, those completing internships were rated higher on two performance style measures: initiative/self-assurance and dependability. In general, supervisors' ratings tended to be higher than graduates' self-ratings.

Dietetics↗

The nurse internship experience: a dynamic learning environment for the novice.

This article highlights the history of nurse internship programs and reviews the application process, the content, and the design of a nurse internship program. The program described has proven to be a developmental process for the nurse intern, the preceptor, and the staff development specialist. Recommendations are presented for implementation of a successful nurse internship program.

Education, Nursing, Continuing↗

[Internship in a community hospital. Experience gained in the "Faculdade de Ciências Médicas e Biológicas de Botucatu" (author's transl)].

Currently the verification of the equivalence between an University Hospital (U.H.) and a Community Hospital (C.H.), in means of internship accomplishment is an important subject. The F.C.M.B.B. has accumulated experience in this matter, since among the 514 doctors graduated at this school, in the period of 1968 to 1973: 309 accomplished their internship at Botucatu (U.H.); and the remainers 205 at C.H.s. The author's purpose was to try to evaluate the existence, or not, of this equivalence. Thus two different questionnaries were elaborated, one that was answered by two kinds of intern's instructors (total 58): the teaching staff of U.H. (33), and the physicians belonging to the staff of one of the C.H.s. The other was submitted to two groups of ex-interns (total: 73): ex-interns from U.H. (53) and from C.H.s. (20). Both, ex-interns and teachers, were selected by chance. The answers were analysed by stablishing a comparison between the two groups: U.H. and C.H. The results were analysed by chi2 (chi-square) using the Yates correction for 2 X 2 tables. They seem to suggest that there is an equivalence between U.H.s. and C.H.s. in means of internship accomplishment, since certain characteristics are observed by the C.H.s.

Brazil↗

[Improvement in the program and methods of conducting an internship in occupational hygiene].

The authors describe their experience gained with conducting internship training in occupational hygiene for graduating students of medical and prophylaxis departments of medical colleges. Special attention is called to the matter of learning by those engaged in internship studies of practical skills of work of a physician-occupational hygienist relating, in particular, to exercising sanitary inspection, both preventive and running, in industrial settings. Measures were proposed to improve the programme and curriculum to be guided by in conducting the above internship training.

Curriculum↗

Trauma internship: a success story.

Internships, valuable mechanisms that bridge the gap between academic preparation and initial clinical experience, are attractive to new graduates who have had limited exposure to different aspects of nursing and want a chance to learn more about a particular specialty. Upon completion of an internship, nurses have a broader knowledge base than those who have had an indepth orientation to just one nursing unit. This article describes the development and implementation of a trauma internship in a 570-bed tertiary care, level I trauma center. Program components and evaluation are presented.

Curriculum↗

A comprehensive pediatric rehabilitation nurse internship program.

A comprehensive internship program was conceived at Mount Washington Pediatric Hospital in Baltimore to recruit and train new nursing employees in pediatric rehabilitation. The Pediatric Nurse Internship Program was designed to provide extensive theory relevant to pediatric rehabilitation nursing, as well as preceptor-based clinical experiences, to ease the transition of new nurses into the pediatric rehabilitation arena. The program incorporated a strong interdisciplinary team approach. The content areas included all the functional parameters of health as well as didactic information about the diagnoses specific to the pediatric population. The goal was to allow the intern to achieve clinical competence in pediatric rehabilitative nursing. Four nursing interns were enrolled in the 12-week program, which involved completing an educational project, taking a written examination, and demonstrating evidence of clinical competencies. On completion of the program, three interns transferred into full-time positions at the hospital and demonstrated an extremely high level of functioning. Partial support for the program was provided through grant money from the Maryland Health Services Cost Review Commission.

Education, Nursing, Continuing↗

Stress during internship: a prospective study of mood states.

Mood changes of interns during the internship year were studied using the Profile of Mood States (POMS), a standardized adjective checklist. All 35 interns in the University of California, Irvine-Long Beach Medical Program completed the POMS at internship orientation and at five other times during the year. Of the six mood factors measured by the POMS, four changed significantly during the testing period. Anger-hostility scores were higher (p less than 0.01) in December than at orientation and remained so throughout the year. Tension-anxiety scores were higher (p less than 0.01) and fatigue-inertia scores were lower (p less than 0.01) at orientation than at any other time during the year. Vigor-activity scores were higher (p less than 0.01) at orientation than at the end of the year. Depression-dejection and confusion-bewilderment scores did not change significantly during the study period. Recognition of these mood changes is helpful for drawing the attention of house staff and faculty members to emotional stresses of training, and for identifying issues for discussion in intern support groups.

Adult↗

Direct economic benefits associated with dietetic internships.

OBJECTIVE: We explored the direct economic benefits of hospital dietetics departments sponsoring an internship for dietetics studies. DESIGN: Forty-five dietetics departments in US hospitals participated in a mail survey that involved comprehensive data collection procedures using three instruments, including activity logs recorded by 298 dietitians and interns. MAIN OUTCOME MEASURES: Direct benefits were defined as the net student labor provided to the department during routine and staff relief experiences that released professional labor for other work. Net student productivity during routine assignments was calculated by subtracting the time dietitians spent teaching during a typical work week from the amount of time dietetic interns spent performing professional services without direct supervision. Student productivity during staff relief rotations was calculated by multiplying the number of students assigned to this type of experience by the length of the rotation. RESULTS: While involved in routine learning experiences, dietetic interns provided a direct benefit. The difference between the time interns spent in independent, professional service in the departments and the time dietitians spent in activities designed specifically for teaching was a mean of 29 hours in favor of the students. All departments received a direct benefit from assigning dietetic interns to a staff relief rotation. The median number of weeks of student labor gained by the departments per year was 24. STATISTICAL ANALYSES: A paired t test was used to analyze the difference between the time dietitians devoted to teaching interns and the time students spent in independent, professional service in the departments. The difference was very highly significant (P < .001) APPLICATIONS: This study is a beginning step in objectively documenting positive outcomes associated with sponsoring a dietetic internship. It also represents a model that could be used by program directors to study the economic impact of their supervised practice program on the sponsoring organization.

Cost-Benefit Analysis↗

The relationship between assessment measures at Newcastle Medical School (Australia) and performance ratings during internship.

This study examined the utility of the domain assessment measures used in the final 2 years at Newcastle medical school in predicting performance ratings in the first year of postgraduate training (internship). Performance ratings were obtained from the clinical supervisors of two graduating classes of the University of Newcastle medical students during their five terms of internship. Three or more ratings were obtained from 57% of interns. Univariate analysis indicated that scores for three of the five domains (professional skills; identification, prevention and management of illness; self-directed learning) were significantly positively correlated with intern performance ratings. Multivariate analysis indicated that only the domain assessing identification, prevention and management of illness was predictive of higher intern performance ratings. The results support the notion that there is some value in the domain assessment model used at Newcastle in predicting the performance of junior doctors.

Australia↗

Selection criteria for clinical neuropsychology internships.

Criteria used in the evaluation and selection of applicants for clinical neuropsychology internships were identified by a survey of the programs listed in The Clinical Neuropsychologist. Neuropsychologists from 40 programs replied to the survey, yielding an 80% response rate. Clinical experience in neuropsychological assessment, specialization in clinical neuropsychology during graduate training, personal interview, and letters of recommendation were reported to be the most salient selection criteria. Practica that provide experience with flexible batteries at university-affiliated medical centers and doctoral curricula that follow INS/APA Division 40 guidelines, with teaching and supervision provided by neuropsychologists were preferred prerequisites to internship. Selection criteria reflect a vertically integrated model of education and training in accordance with the Houston Conference model.

Curriculum↗

Career choice and experience of distress amongst interns: a survey of New South Wales internship 1987-1990.

Successive cohorts of interns assigned to a Sydney teaching hospital since 1987 were interviewed at the beginning and end of their intern year to document factors influencing career choice and psychological morbidity, with comparisons between the graduates of the three NSW medical faculties. Intellectual challenge and altruism were the two most reported motivating factors in choosing Medicine. Many interns expressed regret at their career choice. Apart from anger, self-reported psychological morbidity during internship was low. Interns' evaluation of the relevance of their undergraduate training declined during internship, except for Newcastle graduates. Increased "hands on" clinical experience during undergraduate years, career guidance, assertiveness training, and time management skills should be included in the undergraduate curriculum. More registrar teaching, frequent performance feedback, regular grievance sessions and decreased clerical activities contribute to more enriching intern experiences.

Adult↗