Review of intern preparedness and education experiences in General Medicine

Gome, James J; Paltridge, Debbie; Inder, WJ

doi:10.1111/j.1445-5994.2007.01502.x

Cited by 32 publications

(43 citation statements)

References 12 publications

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“…Studies from the UK, the USA and Canada report short‐term but modest increases in students’ factual knowledge and continued difficulty in seeing how to apply it in practice 13,14,19,26,27,34,37–39 . Open‐ended case analysis may increase students’ knowledge of legislation and their ability to use this knowledge in their decision making 57 .…”

Section: Resultsmentioning

confidence: 99%

Towards effective outcomes in teaching, learning and assessment of law in medical education

Preston‐Shoot

McKimm

2011

Medical Education

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Medical Education 2011: 45: 339–346 Context Law is slowly emerging as a core subject area in medical education, alongside content on the ethical responsibilities of doctors to protect and promote patient health and well‐being. Curriculum statements have begun to advise on core content and methods for organising teaching and assessment. However, no comprehensive overview of approaches to the delivery of this law curriculum has been undertaken. Objectives This paper reports an assessment of the nature and strength of the published evidence base for the teaching, learning and assessment of law in medical education. It also provides a thematic content overview from the best available literature on the teaching of law to medical students and on the assessment of their legal knowledge and skills. Methods A systematic review of the evidence base was completed. Detailed scrutiny resulted in the inclusion of 31 empirical sources and 11 conceptual papers. The quality of the included material was assessed. Results Significant gaps exist in the evidence base. Empirical studies of the teaching of law are characterised by insufficient sample sizes and a focus on individual study programmes. They rely on measures of student satisfaction and on evaluating short‐term outcomes rather than assessing whether knowledge is retained and whether learning impacts on patient outcomes. Studies reveal a lack of coordination between pre‐ or non‐clinical and clinical medico‐legal education. Although evidence on the development of students’ knowledge is available, much learning is distant from the practice in which its application would be tested. Law learning in clinical placements appears to be opportunistic rather than structured. Conclusions The place of law in the curriculum remains uncertain and should be more clearly identified. A more robust knowledge base is needed to realise the aspirations behind curriculum statements on law and to enable medical students to develop sufficient legal literacy to manage challenging practice encounters. Further research is needed into effective methods of teaching, learning and assessing legal knowledge and skills during and following initial medical education.

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Section: Resultsmentioning

confidence: 99%

Towards effective outcomes in teaching, learning and assessment of law in medical education

Preston‐Shoot

McKimm

2011

Medical Education

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“…However, the transition from medical student to junior doctor is a significant one and there is evidence from multiple countries that many commencing interns feel ill-prepared to deal with their new responsibilities [4-11]. Areas of particular concern in relation to intern preparedness appear to vary somewhat between jurisdictions, but include: clinical decision making [4,6,8], the management of emergencies [4,6,7,9,11], communication of difficult news [6,7,10], and the performance of practical procedures [4,7,9]. …”

Section: Introductionmentioning

confidence: 99%

A randomised controlled trial of extended immersion in multi-method continuing simulation to prepare senior medical students for practice as junior doctors

et al. 2014

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BackgroundMany commencing junior doctors worldwide feel ill-prepared to deal with their new responsibilities, particularly prescribing. Simulation has been widely utilised in medical education, but the use of extended multi-method simulation to emulate the junior doctor experience has rarely been reported.MethodsA randomised controlled trial compared students who underwent two, week-long, extended simulations, several months apart (Intervention), with students who attended related workshops and seminars alone (Control), for a range of outcome measures.ResultsEighty-four third year students in a graduate-entry medical program were randomised, and 82 completed the study. At the end of the first week, Intervention students scored a mean of 75% on a prescribing test, compared with 70% for Control students (P = 0.02) and Intervention teams initiated cardiac compressions a mean of 29.1 seconds into a resuscitation test scenario, compared with 70.1 seconds for Control teams (P < 0.01). At the beginning of the second week, an average of nine months later, a significant difference was maintained in relation to the prescribing test only (78% vs 70%, P < 0.01).At the end of the second week, significant Intervention vs Control differences were seen on knowledge and reasoning tests, a further prescribing test (71% vs 63% [P < 0.01]) and a paediatric resuscitation scenario test (252 seconds to initiation of fluid resuscitation vs 339 seconds [P = 0.05]).ConclusionsThe study demonstrated long-term retention of improved prescribing skills, and an immediate effect on knowledge acquisition, reasoning and resuscitation skills, from contextualising learning activities through extended multi-method simulation.

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“…During internship training, trainees learn clinical skills, perform clinical procedures, develop good clinical judgment, and acquire communication skills relevant to patient care 2–6. There exists wide intra78 and inter9–12 specialty variations in interns’ clinical knowledge and skills base.…”

Section: Introductionmentioning

confidence: 99%

“…Previous surveys of the clinical knowledge and skills of medical interns have been dominated by assessments of their general medical skills;14–69–12 skills in non-ophthalmic specialties,278 with only few studies15–18 specifically evaluating ophthalmic knowledge and skills. The paucity of ophthalmology-specific surveys despite their established usefulness in generating critical feedback on undergraduate ophthalmic curriculum planning15 is disconcerting.…”

Section: Introductionmentioning

confidence: 99%

Assessing the knowledge and skills in clinical ophthalmology of medical interns: Survey results from Enugu, South-Eastern Nigeria

Eze

Oguego

Uche

et al. 2012

Middle East Afr J Ophthalmol

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Purpose:To compare the skills and knowledge of clinical ophthalmology among medical interns in Enugu, Nigeria, to the recommendations of the International Council of Ophthalmology (ICO).Materials and Methods:A questionnaire-based cross-sectional survey was conducted of Medical Interns attending the University of Nigeria Teaching Hospital and Enugu State University Teaching Hospital, from April 2010 to June 2010. Data on cohort demographics, undergraduate ophthalmology exposure, clinical skills and diagnostic competencies were collected and analyzed. Statistical significance was indicated by P < 0.05.Results:The cohort comprised 81 males and 48 females (sex ratio = 1.7 : 1), aged 21–35 years (mean: 26.8 ± 2.4 years). The gender difference was significant (P < 0.05). The response rate was 88.7%. The duration of undergraduate ophthalmology exposure ranged from 1 to 4 weeks. Exposure was often adequate in cornea/external eye (95.3%), lens/cataract (95.3%) and glaucoma (92.2%); but not in vitreo-retinal disease (47.3%), neuro-ophthalmology (45.7%) and refractive surgery (0.0). The majority were competent at visual acuity testing (97.7%) and visual field examination (93.0%). There was lower competency at anterior chamber assessment (49.6%) and slit-lamp examination (39.5%). The majority could confidently diagnose conjunctivitis (96.1%) and cataract (90.7%), but not strabismus (42.6%) or macular degeneration (20.2%).Conclusions:Medical interns in Enugu displayed gaps in their undergraduate ophthalmology exposure, clinical knowledge and skills. This has implications for stakeholders in medical education and eye care delivery. Review of the curriculum, provision of training resources and compliance with ICO guidelines could address the deficiencies.

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Review of intern preparedness and education experiences in General Medicine

Abstract: Interns at St Vincent's Hospital have been adequately prepared for their role in General Medicine, although many realize this only in retrospect. Deficiencies in educational opportunities for interns have been uncovered that emphasize areas of attention for medical educators.

Cited by 32 publications

References 12 publications

Towards effective outcomes in teaching, learning and assessment of law in medical education

Towards effective outcomes in teaching, learning and assessment of law in medical education

A randomised controlled trial of extended immersion in multi-method continuing simulation to prepare senior medical students for practice as junior doctors

Assessing the knowledge and skills in clinical ophthalmology of medical interns: Survey results from Enugu, South-Eastern Nigeria

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