Internship Preparatory Clinical Course: A Timed-Station Approach to Bridging the Theory-to-Practice Gap

Abstract

Background: Medical students' transition to internship has a discernible gap in structured preparation, particularly in practical skill application. We introduced the internship preparatory clinical course (IPCC) to address this gap. Methods: The course was conducted at the clinical skills and simulation center at King Saud University Medical City and included a total of eight skills distributed across four stations. It employs a timed-station methodology, inspired by the Observed Structured Clinical Examination, but innovatively adapted as a teaching method. Participants were exposed to various stations, such as suturing techniques, interactive mannequins for anatomical structure demonstration, real ultrasound machines on simulated patients, IV cannulation, and urinary catheterization. To facilitate active learning, participants received course materials a day prior, equipped with QR codes for quick reference. Instructors emphasized on-the-spot review, fostering an environment where learners actively engage. Toward the end of the course, after internship a follow-up survey was administered to obtain feedback, achieving a response rate of 83% (n=45/54). Results: Feedback from the course was overwhelmingly positive, with 91.1% (n=41/45) rating the course as 7 and above out of 10. Participants expressed a higher degree of confidence in providing wound care (Median: 8, IQR: 2) and inserting or removing a Foley catheter (Median: 8, IQR: 4). Lower confidence was observed in stoma examination and care (Median: 5, IQR: 4). During their internships, participants reported that 100% (n=45/45) utilized suturing skills, 48.9% (n=22/45) performed focused assessment with sonography in trauma (FAST) examinations, and 62.2% (n=28/45) attempted nasogastric tube insertions. Additionally, 88.9% (n=40/45) performed wound examinations, 77.8% (n=35/45) provided wound care and dressing, 37.8% (n=17/45) performed abscess drainage, 51.1% (n=23/45) removed and 37.8% (n=17/45) inserted a Foley catheter, and 20% (n=9/45) provided stoma care. Conclusion: The IPCC effectively addresses the existing gap in medical education, bridging the theory-to-practice divide. The innovative use of the timed-station approach emphasizes the importance of active learning. Our results signify the importance of simulation training, as most interns acknowledge the positive impact of the course on their internship. We recommend preparing pre-interns for internships by giving special consideration to the procedural aspects as most associated with medical errors. The timed-station approach can improve cost-effectiveness and enhance responsibility-driven learning.