Enhancing capacity for intern training in the emergency department: the MoLIE project

Abstract

Objective: To evaluate an intern educational project, the More Learning for Interns in Emergency (MoLIE) project, designed to increase intern placements in the emergency department (ED). Design, setting and participants: The study was conducted in the ED of the Royal Brisbane and Women's Hospital, Queensland, in 2008. As well as the usual direct contact with patients, interns had 8 hours per week of “off the floor” structured learning time supervised by consultants. This allowed for an increased number of interns to complete a term in the ED over a 1‐year period. The study was evaluated by an intern exit feedback survey and a senior staff survey. Main outcome measures: Numbers of intern placements in the ED; intern satisfaction with the project; senior medical staff satisfaction with interns’ skills and performance assessments. Results: The number of interns completing a term in the ED increased from 65 in 2007 to 90 in 2008. Overall, the 90 interns surveyed were highly satisfied with their training. Most agreed or strongly agreed that the sessions were relevant and covered the right mix of clinical and professional issues. Most of the 12 senior staff surveyed felt that the participating interns performed slightly or much better than interns in previous years, and that their experience as supervisors and overall patient care were improved. Conclusions: The project successfully combined increased intern numbers with educational outcomes that were well perceived by interns and senior staff, without adversely affecting service delivery or supervision workload in the ED.

Intern underperformance is detected more frequently in emergency medicine rotations

“…The requirement for 10 weeks in EM has become a ‘training bottleneck’, as most states have limited capacity to safely absorb large numbers of additional interns into busy EDs. Some states have offered innovative solutions to this capacity challenge . However, there is considerable pressure to replace the EM rotation with 8 weeks in ‘emergency medical care’, which might include selected general practice environments…”

Exploration of the perceptions of emergency physicians and interns regarding the medical documentation practices of interns

“…During their ED rotation, interns at the PAH participate in two 4 h case‐based tutorials each week with staff EPs. This structured training programme is known as More Learning for Interns in Emergency (MoLIE) and its ability to enhance intern training was demonstrated by Brazil et al …”

Impact of a structured intern education programme on clinical documentation in the emergency department

“…Growth in medical graduate numbers has been particularly marked in Queensland, with internship positions more than double since 2007 . In order to increase the supply of training posts, Queensland Health has provided dedicated funding to Clinical Education Queensland (CLinEDQ) to enhance ED teaching and supervisory capacity.…”