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PubMed2005

Geropsychology:integrated training at the interim level.

The profession of psychology is responding to this culture's rapidly changing problems related to an aging population. A central theme regarding the training of clinical geropsychologists has been that education should be sequentially organized across levels, from undergraduate, to graduate, internship, postdoctoral, and continuing education for current practitioners. This paper addresses issues related to geropsychology training at the internship level. We address the need for such training and consider a generic model that outlines competency areas and activities that should be included in an internship program's geropsychology training component. We discuss further one model for implementing a multi-site, multi-level geropsychology training program, and consider issues the of recruiting, identifying training sites, and coordinating with other disciplines. We then consider future goals and plans.

Aged↗
PubMed1992

Factors influencing medical interns trained at U.W.I. to work subsequently in a rural area in Jamaica.

Recognising the present paucity of doctors trained at the University of the West Indies who are working in rural government health facilities in Jamaica, and its impact on the health services, this study was done to determine the factors influencing the decision of UWI-trained interns to work in these facilities post-internship. A questionnaire was administered to 57 UWI-trained medical graduates presently doing their internship in Jamaica. The results showed that there was no significant difference in the choice of placement with respect to sex, or residential background of the intern, though the latter seemed to indicate a trend. Of those who thought they would work in a rural government health facility, two-thirds would do so immediately post-internship but 50% did not plan to work there for more than five years. Opportunities for postgraduate training and lack of equipment were the most important deterrents to working in a rural government health facility.

Choice Behavior↗
PubMed2002

Software engineering in medical informatics: the academic hospital as learning environment.

In 2001, the revised course Software Engineering has been implemented in the Medical Informatics curriculum at the Academic Medical Center, Amsterdam. This 13 weeks, full-time course consists of three parts: internship, theory and project. All parts are provided in problem-oriented manner with special attention for relevant skills such as project management, documentation and presentation. During the internship, students observe how health care professionals at several hospital wards work and how information supply is organized. In the theory part, students study concepts and methods of software engineering by means of case descriptions and self-directed learning. During the project, they apply their acquired knowledge to an observed, clinical information problem and complete several stages of the software engineering process. Evaluation by inquiry showed that, compared to other courses, students spent more time, and distributed their time more evenly, during the whole period of the course. In conjunction with theory, a combination of internship and project in a hospital seems to provide a surplus value compared to a practical in a computer laboratory. The integration of software theory, clinical practice and problem-based approach, contributed to the enthusiastic, intensive and realistic way students learned in this important topic that might be chosen as a future profession.

Curriculum↗
PubMed1990

Evaluation tools for undergraduate program planning in times of financial austerity.

This article describes the administration and outcome of two evaluation tools developed by faculty of the dietetic program for ongoing assessment of a Plan IV dietetic education program over a 4-year period. Interns and internship directors were asked to evaluate the level of skills and knowledge base of interns compared with their internship classmates. Interns were also asked to rate the effectiveness of undergraduate course assignments and activities for internship preparation. As a result of the surveys, the home economics core course work was deleted, credits were shifted from food science to nutrient metabolism courses, and credits in clinical nutrition were increased. Projects in clinical nutrition and food systems management were modified. The surveys justified program requirements and utilization of resources, and provided an additional, effective measure of faculty competence.

Curriculum↗
PubMed1989

Incorporating hard boxes and soft bubbles into the dietetics curriculum.

Dietitians have been challenged to learn the skills of creative thinking in order to become proficient managers in a rapidly changing world. We reviewed the literature to determine the prerequisites of creative thinking and assessed the management and administrative dietetics curriculum for our dietetic internship to determine whether those prerequisites were being met. A major concern in the dietetics profession is that students are not being adequately prepared to assume top management positions. A review of business school curriculums reveals that an emphasis on management theory and quantitative analysis does not adequately prepare students to function effectively in a world where creative problem solving is required. Effective managers at high levels of responsibility rely on intuition and hunches in addition to logical thought processes. Two thinking models are employed by managers--a rational one (hard box) and an intuitive one (soft bubble). These thinking models, or cognitive styles, can also be defined as left and right brain skills. Effective managers use left and right brain skills plus a combination of the two, or integrative brain skill. We reviewed the competencies, behavioral objectives, and planned experiences for the management level rotations of our dietetic internship to develop a conceptual model for the use of right, left, or integrative thought processes. We discovered that although integrative brain skills are used at all levels of our management rotations, especially the top management rotation, no rotation exclusively fosters right-brain skill development. A dietetic internship offers a fertile environment for developing the creative problem-solving skills that are required in management positions in the health care profession today.(ABSTRACT TRUNCATED AT 250 WORDS)

Administrative Personnel↗
PubMed1989

A brief history of graduate medical education in Washington, Alaska, Montana, and Idaho.

Internships and hospital-based medical education preceded by more than 40 years the beginnings of a medical school in Washington State. Just after the turn of the 20th century, a few internships were begun by hospitals in Seattle and Spokane to help with the care of their sicker patients in the tradition of Eastern teaching hospitals. In the 1920s and 1930s, the number of hospitals with internship programs grew steadily as part of a nationwide effort at hospital standardization. Experiences in developing these programs and problems with intern recruitment contributed to the beginning of the University of Washington School of Medicine after World War II. Since the 1960s, intern and resident training has progressively become a cooperative effort of the school with many hospitals and clinics in Washington, Alaska, Montana, and Idaho contributing to the development of graduate medical education in this region.

Alaska↗
PubMed1985

[Effects of social origins and professional socialization on the vocational preferences of medical interns in Mexico].

Using data from a survey of 923 medical interns in Mexico, this article analyzes preferences for type of medical activity (general or specialized practice), type of site (ambulatory or hospital), and type of medical care institution (public assistance, social security, or private). Four independent variables are examined: social origin, medical school, place of internship, and assimilation to the internship hospital. The great majority of the interns expressed a preference for specialty practice, hospitals, and social security institutions. The role of social origin was to selectively direct students into different medical schools. From then on, the structural attributes of the school itself and of the place of internship, as well as the socialization experiences that took place there, emerged as the most important determinants of career preferences. Such a process, however, tended to produce a "social specialization" of interns in terms of the role they expect to play in the medical field. It is argued that this kind of specialization has negative implications for the professional status of physicians, although it also poses a challenge to the development of innovative theories about the process of professionalization in medicine.

Career Choice↗
PubMed1995

[Is the training of interns in practical clinical skills adequate?].

In Norway the preregistration internship consists of 12 months service in hospitals followed by 6 months in general practice. This survey assessed to what extent the intended practical skills had been aquired during the hospital service. A questionnaire was sent to all preregistration house officers who had recently completed their internship. 104 out of 133 responded (78%). Most of the house officers reported that they had received training and instruction in basic medical and surgical skills. However, more than 30% received no formal supervision in various emergency medical skills and the reported instruction in gynaecological skills was even worse. The female house officers were less likely than their male colleagues to report that they had attained various practical clinical skills. There was substantial variation in skills among respondents from different hospitals. Further studies into the quality of the preregistration internship, and the value of specific interventions, seem to be justified.

Clinical Competence↗
PubMed1999

Blood, vomit, and communication: the days and nights of an intern on call.

Internship year is the first year of a medical residency, and often the hardest due to an intern's amount of work and lack of experience. This research provides an evocative account of the internship context based on observations of an intern, who was shadowed during 2 of his nights on call. The author describes the fragmented, chaotic, and exhausting experiences of an intern. This descriptive account contrasts with current health communication literature, in that it recognizes a specific context rather than assuming a nondescript clinical setting. Conclusions suggest that the experiences of internship year offer little opportunity to develop the communication skills necessary for a physician's later clinical career. In addition, health communication researchers must strive to better understand medical training by more frequently entering the trenches in which interns work. Such research will serve to advance interpersonal communication within specific health care contexts.

Journal Article↗
PubMed1992

Development of moral judgment and its relationship to the education and training of dietitians.

The purpose of this study was to compare the development of moral judgment in 171 dietetics students before and after training from internships (n = 96), coordinated undergraduate programs (n = 61), and preprofessional practice programs (n = 14). The results of the study supported the research hypothesis that greater moral development growth would occur in supervised practices that allow students more experiences promoting moral growth, such as clinical rotations with patients, peer discussions on ethical issues, and access to instructors trained in ethics. Analysis of covariance indicated differences in the posttest scores of the three groups. Student scores for the internship and the coordinated undergraduate program were significantly different. Scores of preprofessional practice program students did not differ from those of the other groups. Internship programs offered more time in clinical rotations, used trained ethicists more, and used more methods to introduce ethics into the curriculum than did the other programs.

Adult↗
PubMed1995

[Training of urologists].

Urologists in France are combining classical teaching programmes and innovative cooperative efforts to better train their future colleagues. Candidate urologists participate in a 2-year programme during the last year of the 5 year general surgery internship and an additional post-internship year. Courses in anatomy, infectiology, oncology, and tissue repair are given together with special courses in emergency surgery and urology. An innovative project developed by the French College of Urology invites trainees to participate in cooperative national seminars on a specific theme. Each seminar is proposed conjointly be at least two teams in different university hospitals. This provides fruitful exchange of techniques and opinions between teams and offers trainees a stronger trainer-trainee relationship with a larger number of established leaders. The programme is regularly assessed by the College. These theoretical training sessions are completed by clinics in general and digestive surgery, orthopaedic surgery and at least 2 years in an urology clinic. The post-internship year is essential for the future urologist. As "chef de clinique" in an urology unit, he has immediate responsibility for patient care under the guidance of a senior and is progressively give total control of the most sophisticated procedure. The French College of Urology is currently examining proposals for determining accreditation criteria for teaching centres and continuous evaluation of the objectives for practical training within the framework of the associations of national urologists working together in the European Board of Urology.

Foreign Medical Graduates↗
PubMed1992

Assessing medical interview performance. Effect of interns' gender and month of training.

Observation of history taking is commonly used to assess interviewing skills in medical internships, yet specific interviewing problems are infrequently documented. We evaluated videotaped recordings of 83 complete medical histories of new patients for content and questioning technique. Frequent deficiencies were found in history of medication compliance, gynecologic and psychiatric history, use of open questions, and mental status examination. The initial segments of 48 interviews were evaluated, and in 44% the patient was not allowed to complete their opening statement of concerns. Female physicians allowed fewer patients to finish their opening statement, and physicians at the end of the internship permitted the patients less time to express their concerns. Structured evaluation of complete histories reveals frequent interviewing problems as well as possible important effects of physician gender and length of training.

Age Factors↗
PubMed2003

The origins, history, and design of the resident match.

In the early 1900s, competition among hospitals for interns and among medical students for good internships led to increasingly early offers of internships to students. By the 1940s, appointments were often made as early as the beginning of the junior year of medical school. Hospitals thus had little information about students' performance, and students frequently had to make a final decision to accept or reject an offer without knowing which other offers might be forthcoming. From 1945 through 1951, efforts were made to enforce a uniform date for accepting offers. However, students were still faced with offers having very short deadlines, compelling them to accept or reject offers without knowing what other offers might be forthcoming. Hospitals often had to scramble for available students, since if an offer was rejected, it was often too late for them to reach their next preferred candidate. A centralized clearinghouse was thus developed as a way of alleviating this chaos and allowing a larger role to the preferences of both students and hospitals. This evolved into the current matching program, whose algorithm continues to be updated to take account of changing needs of applicants, such as growth in the number of couples who seek 2 positions in the same vicinity.

Algorithms↗
PubMed1981

Differentiating roles of clinical and counseling psychology interns.

Asked 60 clinical psychology interns and 54 counseling psychology interns from 18 APA approved university training programs to complete a survey form that involved rating the amount of emphasis placed upon various roles, functions and duties at internship and university training programs. Supervisors of the interns at the respective internship settings completed analogous forms, rating their perception of the degree of emphasis placed upon various roles, functions and duties. The data were analyzed via stepwise discriminant analysis to determine whether some roles would be more typical to one specialty. Finally, suggestions were offered for the improvement of university training programs and for the conduct of further research on roles of the two specialties.

Counseling↗
PubMed1993

The fourth-year medical school curriculum: recommendations of the Association of Professors of Gynecology and Obstetrics and the Council on Resident Education in Obstetrics and Gynecology.

OBJECTIVES: The Association of Professors of Gynecology and Obstetrics and the Council on Resident Education in Obstetrics and Gynecology have proposed a fourth-year medical school curriculum for a student interested in pursuing a residency in obstetrics and gynecology. STUDY DESIGN: Faculty members and residents in North Carolina, Illinois, and Michigan were surveyed as to the ideal curriculum that they would recommend for fourth-year students. The committee members representing the Council on Resident Education in Obstetrics and Gynecology and the Association of Professors of Gynecology and Obstetrics then reviewed these surveys and proposed a final curriculum. RESULTS: A core curriculum of general medicine as an acting internship, an intensive care unit rotation, neonatology, and emergency medicine was recommended. Additional courses strongly considered were ambulatory obstetrics-gynecology, acting internship in obstetrics-gynecology, endocrinology, and general surgery. CONCLUSION: The committee recommends a curriculum that is broad and balanced in general medical education.

Curriculum↗
PubMed1986

A successful psychiatric training program for medical residents.

The psychosocial skills of 24 PGY I medical residents receiving psychiatric training every other week during the internship year were evaluated and compared to a control group of 13 PGY I residents. After the internship year, the psychiatrically trained residents showed an increase in their ability to recognize emotional problems, whereas the control group recognized less depression. Psychiatrically trained residents were more sophisticated in psychosocial problem descriptions and plan formulations, whereas the control group formulated more poor psychosocial plans.

Clinical Competence↗
PubMed1983

Career preferences and perceptions of the medical labor market among Mexican interns.

This paper examines the relationship between choice of career and perception of the medical labor market, as well as the effects of social origin, type of medical school, and place of internship. The data are derived from a survey of interns which was conducted in Mexico during 1978, when a substantial proportion of physicians was unemployed or underemployed. Career preferences were operationalized in terms of type of activity (general practice or specialty), site (ambulatory or hospital) and institution (public assistance, social security or private). Perceptions of the medical labor market were measured as an 'objective' feasibility perception and a 'subjective' opportunity assessment. Additionally, composite indices of career preferences and perceptions were constructed in order to take account of two integrated career patterns: dominant (or majority preference) vs alternative (or minority preference). Analysis of the data consistently revealed that perception of the medical labor market had a much stronger impact on preference for alternative than for dominant career patterns. Whereas social origin had no effect on career preference, type of medical school and place of internship exhibited a statistical interaction with career preference, suggesting that certain structural conditions of the medical school and the teaching hospitals led to preference for alternative rather than dominant careers. The implications of the findings are discussed with regard to health manpower policy, to conceptions of rational career choice and to the professional status of medicine in Mexico.

Analysis of Variance↗
PubMed1987

1986 Association of Residents in Radiation Oncology Survey.

Two simultaneous surveys were conducted by the Association of Residents in Radiation Oncology (ARRO). A survey of all residents in Radiation Oncology was conducted to obtain information on trends in residency training. A simultaneous survey of Chief Residents was obtained to determine more specific information on current training programs. Over one-half of residents responded. Eighty-eight percent of respondents were graduates of a North American medical school. Most did at least an internship prior to entering Radiation Oncology and 3/4 of those who did not do a separate internship rotated through other areas at a later time to broaden their knowledge. One-half are Board certified or Board eligible in another specialty or hold a Masters or Ph.D. degree. Three-quarters of all residents had authorship of at least one paper during training and one-half were primary authors. Eighty percent felt adequately prepared for practice after residency. One-half plan at least an initial post-residency affiliation with an academic center. Many were concerned that Radiation Oncologists are not afforded respect equivalent to that of other specialties. Ninety-eight percent favored departmental status for Radiation Oncology. Resident recommendations for improving the image of Radiation Oncology are presented.

Education, Medical, Continuing↗