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This article gives a brief summary of a student project required in a perioperative internship program in a large medical center hospital. The Perioperative Nursing Data Set (PNDS) was used to determine activities necessary in developing a nursing care plan for patients undergoing cystoscopy. The project description and the total care plan is shared with the reader.
The University of Iowa Hospitals and Clinics Dietetic Internship Program has developed a series of workshops and assignments to enhance the writing skills of interns. Three workshops cover basic writing skills, development of materials for the lay public, and basic elements of journalistic writing for professional audiences. The interns received a variety of assignments throughout the year to build competencies learned in these workshops. Evaluation forms have been developed to make assessing the assignments easier for the instructors and to give feedback to the interns. Evaluation reports from interns and graduates indicate that the program is effective and appreciated.
In the nineteenth century, clinical education in the United States was entirely didactic. Medical students attended lectures all day and were expected to commit the many details to rote memory. In the modern era, the clinical clerkship transformed students from passive observers to active participants in the learning process. In addition, the internship and residency provided learners the opportunity to assume responsibility in patient care. The strength of this clinical experience depends not only on the will of medical faculties but on the quality of the hospital learning environment.
Family practice residency training in Venezuela is designed to prepare physicians to meet the health needs of the nation at a time of increasing societal concerns for the quality and cost of care. Since 1982, nine residency programs have been created throughout the country. Each two-year program is based in an ambulatory care setting. Entering physicians have completed an internship and have a minimum of two years practice experience. Graduates have been prepared to continue a socially active role to promote the new specialty. Training emphasizes community aspects of clinical practice, similar to the hopes of community-oriented primary care in the United States. Additional emphases include exposure to clinicians from other specialties, family aspects of patient care, working with a health care team, completion of a research project, and structured courses of theory in areas such as public health, behavioral medicine, and research methodology. Although hampered by economic constraints, the movement's intensely committed leaders have successfully captured political and public support.
Formal lectures have generally replaced case presentations as teaching tools for group learning in internship and residency programs. This article discusses two forms of case presentations--"traditional" and "chunked." Best used to convey medical information, the traditional approach proves less than optimal as a tool in teaching problem-solving skills. The "chunked" method, on the other hand, is an excellent format for formal small- and large-group instruction. An overview and suggested approach for each type is outlined herein. Properly used, each type can be a more efficient, effective tool than lectures when it comes to teaching medical problem-solving skills.
PURPOSE: The purpose of this study was to use Postdoctoral Application Support Service (PASS) data to study the quality and demographic trends for pediatric dentistry residency applicants. METHODS: PASS data on grade point average (GPA) and National Dental Board Exam, Part I (NBI) scores were used to determine applicant quality. PASS demographic data included: (1) gender; (2) citizenship; (3) ethnicity; (4) previous practice of dentistry; and (5) completion of a residency or internship. RESULTS: GPAs showed a significant increase for the 6 years investigated. NBI scores also indicated a significant increase. Significantly more females than males applied to pediatric dentistry residencies. A significant increase in US/Canadian applicants was found. Ethnicity was similar to that of dental school graduates, with minor exceptions. In several of the years studied, there were significant differences in applicants who previously practiced dentistry or completed a residency/internship vs applicants who had no such previous experience. CONCLUSIONS: Significant increases in grade point averages and National Dental Board Exam, Part I scores suggest a high quality of pediatric dentistry residency applicants and this trend seem to be continuing. There are significantly more female than male applicants. More research is warranted on actual acceptance data.
The article summarizes a 10-year experience of teaching general practitioners in internship. Different kind of teaching in the 1-year term was described as well as given questionnaire design results of internists to be. Intership organization development was considered in the article, it will help the work of general practitioners to be more effective.
The rapid development of medical industry in the last 5 years in Turkey led to an increased demand for medical technicians and secretaries. The aim of this study was to evaluate the level of knowledge of students in Occupational School of Medical Documentation and Secretary about the clinical specimens, and to estimate the need for an additional education on clinical specimens. Four hundred and forty eight students from eight universities were participated to this questionnaire survey. Mean age of the participants were 20.4+/-1.66 years and 342 (76.3%) of them were female students. The mean answer rate of students to the questions about clinical specimens was found 3.4+/-1.9% (min-max: 0-10). Correct answer rates were similar for both first and second year students. There was a negative relationship between the educational year and the rate of correct answer, however the correlation was not significant. Additionally, internship period did not have any effect on the level of knowledge. The results of this survey have indicated that the level of knowledge of medical secretaries about clinical specimens was very low. As the roles and responsibilities of medical secretaries in medical industry increases, in order to increase the cost-effectivity, quality and patient satisfaction, the contents of their education programs must be reorganized, and a lecture about clinical specimens should be integrated.
BACKGROUND: Internship and residency are stressful experiences for physicians in training. Residency programs vary in their provision of supportive services for residents. METHODS: A random sample of 50% of the nation's family practice residency programs was surveyed to determine the prevalence of 19 support services, 10 of which were assessed a decade previously. Programs were also asked about on-call frequency, vacation benefits, and program size. RESULTS: Approximately 91% of the programs responded. The surveys indicated that residents were on call an average of once every four nights, a 10% decrease from a decade ago. The prevalence of three support services had increased over the last decade: seminars and speakers on the stresses and conflicts of being a physician, support groups for residents, and child care services. "Night-float" rotations and part-time residencies are the least offered support services of those studied. CONCLUSIONS: Support for family practice residents is increasing, yet in many cases remains inadequate.
The attitudes of two groups of osteopathic medical interns toward their education are compared. The two groups, referred to as osteopathic ideologists and allopathic ideologists, were selected on the basis of their reported first choice of medical school and internship. The groups differed significantly concerning preparation for and commitment to an osteopathic medical career; adherence to osteopathic tenets; evaluation of quality of education; plans for future training; and career plans. Both groups, however, reported a lack of coherence and integration of osteopathic medical principles and practices in their education. Implications for osteopathic medicine and osteopathic medical education are discussed.
A written case study--or patient management problem--was used to examine how the nutrition care planning process is influenced by increasing clinical experience. The sample consisted of 45 students in diet therapy courses, 46 dietetic interns, and 44 experienced clinical or generalist dietitians. The patient management problem tested data gathering, with sections containing information needed to assess nutritional status, and nutrition care planning, in which subjects identified and evaluated problems and selected short- and long-term goals. Performance was scored by comparing subjects' answers with those of five dietetic experts. Dietitians scored highest and students scored lowest on efficiency of data gathering. Dietitians and interns scored higher than students on proficiency of data gathering and nutrition care planning. Overall, dietitians and interns performed better than students. Only in tasks requiring the highest levels of information processing and/or confidence in clinical judgment were differences between dietitians and interns consistently found. These findings demonstrate that basic nutrition care planning skills are acquired during dietetic internships, but advanced skills are added with clinical experience.
The undergraduate medical curriculum does not include supervised training in emergency services. Medical students and residents are expected to acquire skills and experience related to emergency medicine during their clerkships in the clinical wards. Consequently, Israeli medical graduates often have difficulty in coping with common situations in primary care and emergency medicine. In response to the perceived need of emergency training, we modified the undergraduate teaching program of the clinical clerkship. During their medical clerkship, students spent several weeks in the emergency ward. Residents were similarly assigned to the emergency ward on a rotating basis for 3-month periods. Both the positive feedback of the trainees and the practical relevance of the program and its feasibility, suggest that it may be a worthwhile addition to the undergraduate and graduate clinical curriculum. However, we have no data for evaluating the outcome. We feel that all aspects of emergency medicine should be included in the teaching programs of the various clinical specialties, and suggest that the emergency room should be used as a teaching setting during the clinical clerkship, the internship and residency training.
Osteopathic postdoctoral education is still in transition. With a projected modest decline in the number of graduates and continued increase in the number of intern positions, the profession can now accommodate all graduates in osteopathic internships. Changes have been made in the intern program curriculum and in procedures for approval of residency training to be more responsive to the current healthcare environment and needs of osteopathic graduates. The AOA Department of Education will continue to monitor and report on the impact of these changes.
Cumulative figures of "average medical student indebtedness," although meaningful, do not convey the effect of loan repayments on residents' cash flow, effect on a resident's value system and residency performance, and effect on trends in health care manpower allocation. Using a computer-based cash flow model, a "typical" house officer with $20,000 in undergraduate indebtedness who is training in a less expensive city will realize a $2390 deficit during internship and negative cash flow throughout a 5-year residency. House officers with extreme indebtedness (greater than $80,000) who are training in an expensive metropolitan area would accumulate an overall deficit approaching $75,000 or more, in excess of their undergraduate indebtedness, during a 5-year residency program. Effects of these findings on residency education and health care manpower issues, along with potential solutions for alleviating residents' cash flow problems, are discussed.
On the premise that empathy is important in patient care and nutrition counseling, the empathy levels of 217 clinical dietitians and 168 dietetic interns were measured using the Davis Interpersonal Reactivity Index. The Interpersonal Reactivity Index is designed to measure four aspects of empathy: empathic concern (EC), fantasy (FS), personal distress (PD), and perspective-taking (PT). Personal and professional characteristics were surveyed to determine possible influence on empathy. The instrument was mailed to 26 randomly selected internship programs. All of the dietetic interns and clinical dietitians who spend 80% of their time in patient care were requested to participate. The mean ages of the dietitians and interns were 35 and 25 years, respectively. Interns scored significantly higher on the EC (29.06, p less than .05) and FS (24.65, p less than .0005) scales than the dietitians (EC = 28.20, FS = 22.53). There was a highly significant negative correlation (r = -0.26, p less than .0001) between fantasy and age for dietitians and interns and between fantasy and experience for the dietitians (r = -0.23, p less than .0005). Dietitians and interns who had had graduate coursework in counselling, psychology, and/or educational psychology had significantly lower mean scores on the PD (17.14, p less than .05) and EC (27.82, p less than .05) scales and a significantly higher mean score on the PT (27.06, p less than .05) scale. Responses to an opinion question indicated that the mean for ideal percentage of time spent in direct patient contact was 70.1 for dietitians and 61.4 for interns, a highly significant difference (p less than .0001).(ABSTRACT TRUNCATED AT 250 WORDS)
The National Resident Matching Program (NRMP) was established in the early 1950s to bring order and fairness to a previously chaotic application process for internship and residency positions. Over the years many reservations were raised about the fairness of the process, specifically, that hospital programs are doing better than students are (i.e., programs obtain preferred residents more often than students receive preferred programs). This paper presents an analysis of the results of the 1986 Match. The findings do not support the claim that the results of the Match are biased in a way that favors programs. Overall, the students' success was greater (i.e., receiving on average higher-ranked choices) than was the hospital programs' success. In fact, in 20 of 22 specialty programs, the students' degree of success was greater than or equal to the success of the programs. This finding raises the question of fairness toward programs rather than students. The authors analyze factors that affected both the hospitals' and the students' degrees of success in the 1986 Match and suggest strategies for improving the Match results.
On the basis of the anonymous questionnaires filled by 131 therapeutic interns from 18 higher medical establishments young specialists distinguished certain personality traits which, in their opinions, should be inherent in a doctor; they evaluated training in the institute and during internship and pointed out its shortcomings. The information obtained is important for further improvement of the medical training.
Osteopathic postdoctoral education is still in transition. With a projected modest decline in the number of graduates and continued increase in the number of intern positions, the profession can now accommodate all graduates in osteopathic internships. Changes have been made in the intern program curriculum and in procedures for approval of residency training to be more responsive to the current healthcare environment and needs of osteopathic graduates. The AOA Department of Education will continue to monitor and report on the impact of these changes.