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PubMed2004

Entrepreneurship of dietetic program graduates.

Successful dietetic program graduates must have an entrepreneurial mindset and skills to respond to environmental changes and consumer trends. The purpose of this study was to determine current or intended entrepreneurship by graduates of a Dietitians of Canada accredited university program, as influenced by self-efficacy stemming from entrepreneurial experiences in education or early career, as well as by internal and external factors. This study employed an exploratory descriptive methodology with a questionnaire mailed to a discrete sample. Ninety graduates completed and returned the questionnaire for a response rate of 55%. Data analysis included descriptive statistics, two-way table analysis, the chi-square test for independence, and Fisher's exact test. Significant relationships were found between self-efficacy scores and entrepreneurial action, specific entrepreneurial experiences and entrepreneurial intent and action, dietetic internship and intent, and belief in the importance of business skills and intent. Those with entrepreneurial intent and/or action identified creativity, dietetic education/internship, persistence, business skills, and family/friend support as helping factors. These results suggest that undergraduate, internship, and continuing education programs for dietitians should incorporate activities that develop entrepreneurial skills and contribute toward an entrepreneurial mindset.

Adult↗
PubMed2005

Learning opportunity and preparedness for practice: perceptions from dietetics programs in Canada.

PURPOSE: This study determined dietetics trainees' and program coordinators' perceptions about trainees' preparedness to practice, based on Dietitians of Canada's 145 competency statements. Depth and breadth of learning opportunity were also determined with definitions of these two concepts based on Elliott's view of professional education and practice. METHODS: Research questions were: 1. How prepared were trainees for practice? 2. What were the depth and breadth of learning opportunity in assessment, planning, implementation and evaluation? 3. How many learning opportunities were there in professional practice and communication? 4. Did responses vary between integrated programs and internships or between trainees and program coordinators? RESULTS: Of 313 trainees, 168 (54%) responded and 23 (72%) of 32 coordinators responded. Preparedness was rated as "well prepared" or better for 25 (56%) of the 45 main competencies. For every competency, preparedness ratings were higher in integrated programs than in internships. Learning opportunities were rated as sufficient in depth and breadth or number for 88 (61%) of the 145 competency statements. Low ratings for preparedness were accompanied by low ratings for depth and/or breadth or number of learning opportunities. CONCLUSIONS: The notion of depth and breadth is useful as a framework to assess learning opportunities for developing entry-level competence.

Canada↗
PubMed1988

Interns' identification of patients' health risks in a casualty department.

This study examined whether the interns who staffed a hospital casualty department identified correctly four common health risks among their patients. When compared with patients who were attending general practitioners, patients who attended the casualty department were more likely to be cigarette smokers. They were also more likely to be heavy drinkers of alcohol and to score highly on a standardized measure of psychological disturbance. Women were less likely to have undergone a Papanicolaou smear-examination within the previous two years. The interns, who were the subjects in this study, failed to identify 56% of the smokers, 84% of the heavy drinkers, 35% of the psychologically-disturbed patients and 95% of the women who had not undergone a Papanicolaou smear-test in the last two years. The findings were in contrast with the interns' own opinions on what would constitute good-quality care in this setting. The subjects were just beginning their internship at the time of the study. Their failure to integrate important questions about common health risks suggests that their undergraduate training has been deficient in this area. The internship is the last formal opportunity to correct this deficiency before these doctors are registered for independent medical practice.

Adolescent↗
PubMed2004

Burnout and psychiatric morbidity in new medical graduates.

OBJECTIVE: To determine the prevalence of psychiatric morbidity and burnout in final-year medical students, and changes in these measures during the intern year. DESIGN: Prospective longitudinal cohort study over 18 months, with assessment of psychiatric morbidity and burnout on six occasions. PARTICIPANTS: All 117 students in the first graduating cohort of the University of Sydney Graduate Medical Program were invited to participate in the study; 110 consented. OUTCOME MEASURES: Psychiatric morbidity assessed with the 28-item General Health Questionnaire and burnout assessed with the Maslach Burnout Inventory. RESULTS: The point prevalence of participants meeting criteria for psychiatric morbidity and burnout rose steadily throughout the study period. CONCLUSIONS: Internship remains a stressful time for medical graduates, despite initiatives to better support them during this period. The implications for the doctors themselves and for the communities they serve warrant further attention, including programs specifically aimed at reducing the rate of psychological morbidity and burnout during internship.

Adult↗
PubMed1999

[Self-reported skills in practical procedures among young physicians].

There is at present no consensus as to which clinical procedures a student should be able to perform after graduation. The present study was undertaken to evaluate the self-reported skills level in practical procedures among graduates from the medical schools in Norway. A questionnaire was mailed to all students who entered internship between July 1996 and January 1998. They were asked to indicate on a visual-analogue scale the level of skill he or she had acquired in 88 practical clinical procedures. 519 of 621 (84%) graduates replied; 89% started internship immediately after graduation. Graduates from Tromsø reported significantly better skills than graduates from Oslo and Bergen. There was considerable variation within and between the universities with respect to several procedures. Overall, men reported a significantly better skills level than their female colleges. The present study demonstrates that the skills level in several procedures vary considerably between candidates graduating from different Norwegian universities after undergraduate medical education. For some procedures the skills level is, in our opinion, disquietingly low. The results of this survey indicate that teaching of clinical procedures in medical school is often random and of inferior quality. There is a need for a systematic approach and a national consensus on the clinical procedures to be acquired and the levels of skills to be attained.

Adult↗
PubMed2006

The career aspirations and location intentions of James Cook University's first cohort of medical students: a longitudinal study at course entry and graduation.

INTRODUCTION: James Cook University's School of Medicine enrolled its first cohort of 64 students in 2000. The School was established with the aim of increasing the number of medical graduates who understand rural, remote, Indigenous and tropical health issues and who would subsequently choose rural (non-metropolitan) practice. In December 2005, 58 students graduated the course. Several students left the cohort (either left the course or repeated earlier years of the course). In the early years, students who left the course were replaced by accelerated entry students. METHOD: A student-initiated survey, involving questionnaire and interview components, conducted in 2001 sought information on students' career aspirations and practice location intentions, as well as why students had chosen medicine and the James Cook University course in particular. A brief follow-up survey focused on career aspirations, location of internship and longer term practice location intentions was conducted in October 2005 (2 months before the students graduated). In each instance, participation was anonymous and no identifying information was recorded. Accelerated entry students' responses to the 2005 survey were included. RESULTS: In 2001, 57 (89%) of the 64 students participated in the study; and in 2005, 50 (86%) of the 58 graduating students responded to the questionnaire survey. Overall, the demographic composition of the 'cohort' changed little. In 2001, 66% of respondents intended to practice in non-metropolitan areas, with 64% so intending at graduation. This was reinforced by 64% choosing internship positions in non-metropolitan areas of Queensland; 56% in north Queensland. Career aspirations changed appreciably between 2001 and 2005: the number of undecided students had halved, the numbers interested in general practice had reduced by one-third, the numbers considering surgery had reduced to one-third, and none was considering paediatrics at exit. Conversely, the number considering emergency medicine had almost doubled and more than doubled for obstetrics and gynaecology. DISCUSSION: Given that the majority of intern positions in Queensland are in the south-east of the state, it is noteworthy that two-thirds of students sought and accepted posts elsewhere, predominantly in northern Queensland. Changes in career aspirations reflect two issues. First, respondents' 2005 recollections of what their aspirations were in 2001 varied, reinforcing the value of the longitudinal process. Second, the change of intentions across time possibly reflects exposure to various disciplines and perhaps positive/negative experiences during clinical rotations in the final years of the course. The consistency across time with respect to intention to practice in rural (non-metropolitan) areas suggests that most respondents had eyes on rural practice from early in the course. The findings are in line with other studies that have demonstrated two important factors influence clinicians' decisions to take up non-metropolitan practice: (1) non-metropolitan background; and (ii) substantial and meaningful exposure to non-metropolitan practice during the course. CONCLUSION: The findings support the School's contention and that of others around the world that medical education undertaken in non-metropolitan settings is the best vehicle for increasing the rural medical workforce. This study provides support for the development of regional medical schools that focus on local recruitment and health care need issues.

Adolescent↗
PubMed2006

[How to anticipate specialization at the Examen National Classant (National Entrance Examination) to encourage interns to choose urology].

OBJECTIVES: To analyse the value of an introduction to urology session to recruit interns following the Examen National Classant (ENC) (National Entrance Examination). MATERIALS AND METHODS: Over a 2-year period, interns appointed to surgery in Paris participated in a one-day introduction to urology session before starting work as surgical interns. A questionnaire at the beginning of internship recorded: age, gender, teaching hospital, student attachment in urology and desired specialization as a function of the surgical training programmes proposed by the ENC. Items concerning the desired specialization were resubmitted to the interns at the end of the session. RESULTS: Population. 166 interns, 98 females (59%) and 68 males (41%) with a mean age of 24.8 +/- 5 years (range: 22-31) participated in this study. 110 interns had trained at a Parisian teaching hospital (66.2%) and 56 (33.8%) had trained at a provincial teaching hospital. 31 interns (18.7%) had completed at least one urology attachment during their medical training. Desired specialization: Orthopaedics was the discipline most frequently cited (n=48; 28.9%). Urology was selected by 19 interns (11.4%), 17 of whom had completed an urology attachment during their medical training. At the end of the introduction to urology session, another 15 interns initially oriented towards other specializations were interested in urology training. CONCLUSION: Specialization of certain surgical disciplines during internship could become inevitable in the medium term. In this case, the organization of national introduction to urology sessions in each ENC allocation region would be a solution to encourage motivated interns to immediately choose urology as their surgical speciality by preference rather than by default.

Adult↗
PubMed2006

[Teaching apprenticeship in psychiatric nursing: an experience during the postgraduate period].

I present my experience related to an internship on teaching upon developing activities in the discipline of Psychiatric Nursing II, during the Nursing graduation at Universidade Federal de Santa Catarina in the first semester of 2004. It is a theoretical-practical subject, divided into two blocks. The internships take place in a psychiatric hospital and in the community through domicile visits. I have found out that the psychiatric hospital was the scenario of several significances. The students appreciated the domicile visits, even under a few difficulties. After a discussion based on the relevant literature, I came to the conclusion that this experience was beneficial to me for allowing the integration between graduation and postgraduation.

Brazil↗
PubMed1991

[How one achieves the practice of medicine in Puerto Rico--1990].

We have gathered information of particular interest to students of medicine and recent graduates about the law that regulates the practice of medicine in Puerto Rico. We have also reviewed the current information about how to obtain the examination of the Puerto Rico Board of Medical Examiners, and the requirements to obtain the provisional licenses for postgraduate training (internship and residency), for the compulsory year of government service and for the regular license. We have compared 1980, 1986, and 1990 as to the number of internships in the 28 programs available. At present it is quite likely that physicians with marginal credentials will have a difficult time finding a place in fully accredited programs. Since July 1980 the unauthorized practice of practice medicine is considered a serious offense. The increasing number of malpractice suits and the recent changes in the law have made the practice of medicine in Puerto Rico increasingly risky.

Accreditation↗
PubMed1991

Health Beliefs Model as a template for measurement of intern satisfaction in an ambulatory care clinical training program.

The Health Beliefs Model was originally developed in the 1950s to assess patient behavior toward preventative health strategies, and has evolved into a tool for measuring a variety of health related topics. Interns in an ambulatory care clinical training program were asked to complete a 62 item self-administered questionnaire based on concepts central to a modified Health Beliefs Model for assessment of their satisfaction with their internship program. A logistic regression was undertaken to identify relationships between interns' perceptions toward susceptibility and seriousness of illness, delivery of health care through outpatient clinics, supervisory professional personnel and their overall internship satisfaction rating. The data implies that the modified Health Beliefs Model is of value in predicting intern satisfaction.

Attitude of Health Personnel↗
PubMed1990

[The status and outlook of the training of pathologists in the RSFSR].

Pathology service in the RSFSR suffers, at present, from the lack of pathologists: only 2393 (57.3%) of 4174 positions are occupied. Particularly difficult is the situation in Eastern Siberia and Moscow where only 47.7 and 48.6% positions, respectively, are covered. Lack of professional pathologists is aggravated by an artificial decrease of positions number as compared to real need, by the increase of proportion of persons retired or those having a preretirement age (30%), by a high percentage (over 30% of positions) of persons experiencing pathology as a second profession (65% of them do not have a sufficient knowledge and practice in pathology), by a low level of medical education in general and nonsufficient promotion of pathologists (only 39.3% pathologists have attestation categories). To solve the crisis the RSFSR Ministry of Health started in 1988/89 4-year training of pathologists at the pathology chairs of the RSFSR Medical Institutes: subinternship (1 year), internship (1 year), clinical internship (2 years). The realization of this program will result in turning out of 724 pathologists by 1994. The progress in pathologists training will require the improvement of technical basis of pathology chairs and departments and solution of certain organizational problems.

Certification↗
PubMed1990

[The tasks of pathological anatomy (pathology) in the medical college and the possible means for their resolution].

The course of pathologic anatomy in medical students' training is unsatisfactory as it doesn't cover many aspects of present-day human pathology. The graduates lack necessary knowledge in general and special pathology. The existing system of pathologist training is deficient, it should last for at least 4 years (subinternship, internship, clinical internship). Coordinated plans of advanced training of both the teachers and the pathologists are necessary. The relationships between chairs and bureaus of pathology should be systematized and creation of educational-scientific-practical complexes validated.

Curriculum↗
PubMed1990

[Postgraduate instruction and certification in the system of the continuing education of pathologists].

The experience in changing pathology service, postgraduate training and attestation in the system of continuous education of pathologists is presented. The authors analysed different ways of pathologist training: specialization in subinternship, internship and clinical internship, short-term courses, at places of work and outpatient problem seminars, etc. The four-year program of pathologist training is suggested.

Certification↗
PubMed1989

Education, research, and practice: bridging the gap.

The purpose of this study was to identify the research activities that were part of dietetic internship and coordinated undergraduate programs. Data about required research courses, research-related experiences, curriculum competencies, student publications, and faculty needs were obtained from 79 dietetic internship and 46 coordinated undergraduate program directors. Research courses were required in 60% of the programs and most often included basic statistics and review of the literature. Attendance at research conferences and observation of research dietitians were the most frequent learning experience activities. A wide variety of research projects were required by 71% of the programs, but there were few student opportunities to participate in faculty-sponsored research. The ability to evaluate literature critically, knowledge of research concepts, and application of research findings to dietetic practice were the most frequently cited competency statements. Less than 2% of graduates in a 3-year period had published in professional journals. Faculty members believed they needed more time, money, educational materials, professional development, and access to research facilities to improve the research component of the program. These findings suggest that research competencies may need to be prioritized differently in view of changing needs in dietetic practice.

Dietetics↗
PubMed1978

Enriching personal and professional development: the experience of a support group for interns.

A pilot support group for interns was established at Boston City Hospital early in the internship year to deal with the personal and professional issues arising out of the stresses of the internship. This report describes the functioning of this group, including a statement of goals, content of weekly meetings, and evaluation by group members. In general, the interns felt that the experience was positive and especially valuable in terms of providing support for personal/professional role conflict.

Boston↗
PubMed1995

[Do the interns receive the supervision they are supposed to get?].

The Norwegian preregistration internship consists of 12 months duty as a house officer in hospitals (6 months in a surgical and 6 in a medical department) followed by 6 months in general practice. The survey assesses to what extent the intended information, supervision, feedback and internal evaluation assessment are offered the house officers during their hospital internship. A questionnaire was sent to all preregistration house officers who had recently finished their hospital duty, of whom 104 (78%) out of 133 responded. Half of the "medical" and 65% of the "surgical" house officers reported that they received no introductory information nor supervision before attending hospital duties. Two thirds did not participate in an educational programme and 80% did not receive systematic feedback on their work. Most house officers received no evaluation of their work at all. Specific interventions are needed to ensure high quality clinical training of the preregistration house officers.

Education, Medical, Graduate↗
PubMed1994

Third-year medical student attitudes toward internal medicine.

BACKGROUND: Student attitudes offer insight into career decisions and may suggest causes of the diminished interest in internal medicine. Students entering a salaried managed health care environment may have different attitudes about careers and potential income. Additionally, we evaluate the effect of an ambulatory experience on student attitudes and career selection. METHODS: We surveyed 163 medical students from the Uniformed Services University of the Health Sciences, Bethesda, Md, at the successful completion of the third year to determine their attitudes regarding the work, lifestyle, prestige, patient type, and challenge of internal medicine, as well as primary care interest, and the importance of income in career selection. A subgroup of 107 volunteers was randomized to either the traditional internal medicine clerkship (n = 69), or to 6 weeks of ambulatory medicine and 6 weeks of ward medicine (n = 38). RESULTS: The selection rate was low for internal medicine (10%) and was high for family practice and transitional internships (37%). Although most students highly valued their internal medicine training, relatively few selected internal medicine as a career. Students saw chronic illness and type of work, but not lifestyle, as disincentives toward choosing an internal medicine career. Half of the students believed that income potential would be a major factor in attracting students into internal medicine, and that reimbursement should be shifted from procedural fields to primary care. The ambulatory clerkship did not affect student attitudes nor type of internship selected. CONCLUSIONS: Medicine clerkships, whether traditional or ambulatory, are highly valued educational experiences yet may be insufficient by themselves to attract students to an internal medicine career. Income potential remains an important concern in the setting of salaried managed care, even for students who lack financial debt.

Adult↗
PubMed1994

[Diagnoses in medical and surgical patients. Experiences of a junior physician].

This article presents the diagnoses of 1,078 patients treated during one year of internship in a local hospital in western Norway. The patients were seen in the surgical outpatient clinic or when admitted to the medical, surgical or pediatric departments. In the surgical outpatient clinic the patients usually attended for treatment of fractures, distortion traumas or traumas without fractures. The most common diagnoses in the medical department were related to acute ischaemic heart conditions, whereas the majority of the patients received in the surgical department had acute abdominal pain. Infectious diseases were the most common cause of hospitalization of children. Information about the different diagnosis encountered during work in a local hospital may be of value to others who are preparing to work in similar institutions. Such an internship may provide valuable experience in the diagnosis and treatment of the most common somatic diseases.

Abdomen, Acute↗