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The impact on internship of a tailored intern preparation package

Authors McKenzie S, Mellis C

Received 1 February 2018

Accepted for publication 10 April 2018

Published 7 September 2018 Volume 2018:9 Pages 639—648


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Md Anwarul Majumder

Susan McKenzie,1 Craig Mellis2

1Central Clinical School, 2Education Office, Sydney Medical School, The University of Sydney, Sydney, NSW, 2050, Australia

Introduction: On commencing internship, new medical graduates (new interns) are often required to perform core procedural skills under differing levels of supervision. This variability of knowledge and experience with procedural skills can place patient safety at risk. Consequently, in 2012, we developed a targeted, intensive, 3-day training course for our pre-intern (PrInt) students. The aim of this study was to evaluate the intern preparation package by exploring interns’ self-reported knowledge, confidence, and experience in key procedural skills during the early months of internship.
Methods: Between 2012 and 2016, 5 cohorts of PrInt students (n=223) participated in our course. In the following years 2013–2017, the same 5 cohorts, at 4–5 months into their internship, were surveyed anonymously and invited to attend focus groups. Descriptive statistics and thematic analysis were used to analyze data.
Results: Of the 223 interns, 91 (41%) responded. Of the 91, 82 (93%) agreed that the intern preparation package provided during PrInt had been beneficial to their practice as an intern. Awareness of potential risks to patient safety was high, ranging from infection control at 89/89 (100%) to 87/90 (97%) for patient identification. Confidence in performing procedural skills varied from moderate in identifying nasogastric tube placement on X-ray (66/89; 85%), to equal least confidence in managing cardiac-related emergencies (53/90; 59%) and identifying the correct placement of peripherally inserted central catheter lines on X-ray (52/89; 58%).
Major qualitative findings: The preparation package had refreshed interns’ procedural skills ability and awareness of risks to patient safety. Integration into the clinical team was positive, but requests to perform procedural skills on day 1 was unexpected.
Conclusion: Interns reported that they had gained substantial benefit from their preparation package, and they performed practical procedures from day 1, further highlighting the need for an intensive preparation course immediately prior to entering internship.

Keywords: preparation for medical internship, procedural skills, new interns, junior doctors, teamwork, transitions, patient safety

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