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PubMed · 10354318

Make induction day more effective - add a few problems.

Abstract

INTRODUCTION: Induction courses are important to introduce Pre-Registration House Officers (PRHOs) to their new place of work. Traditionally, such programmes employ lectures, small group discussion and demonstrations. They let PRHOs meet members of various hospital disciplines and services. Since 1991, an interactive induction programme has been held each August for new PRHOs in the Eastern Region of Scotland taking up posts in Dundee Teaching Hospitals NHS Trust. DESIGN: Feedback from participants allows the course to be refined each year. In 1995, three paper-based patient management problems (PMPs) were included in the induction programme. Response was favourable. Most of the participants (82%) suggested the PMPs should be used again, but that more time should be allocated to enable them to tackle the problems. By August 1996, we aimed to provide a relevant and interactive programme that encouraged PRHOs to make immediate use of hospital resources. Two PMPs, in print format described likely case histories, with tasks that mirrored the junior doctors' forthcoming responsibilities. Healthcare team members and laboratory staff provided support as did study boards displaying written sheets of relevant clinical information. RESULTS: In the subsequent evaluation, the PMP component was rated highly by participants. They effectively triggered PRHOs to interact with hospital staff. CONCLUSIONS: We conclude that PMPs provide a valuable learning experience for junior doctors and are a useful addition to an induction day programme. We plan to refine and increase the use of PMPs in undergraduate and postgraduate settings.

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BibTeXRIS

H E Mitchell, J M Laidlaw. 1999. Make induction day more effective - add a few problems.. https://doi.org/10.1046/j.1365-2923.1999.00341.x

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Results of a nationwide Veterans Affairs initiative to align graduate medical education and patient care.

CONTEXT: Planning for the US physician workforce is imprecise. Prevailing policy generally advocates more training in primary care specialties. OBJECTIVE: To describe a program to increase primary care graduate medical education (GME) in a large academic health system-the Veterans Health Administration of the Department of Veterans Affairs (VA). DESIGN: In 1995, a VA advisory panel recommended a 3-year plan to eliminate 1000 specialist training positions and add 750 primary care positions. After assessing the impact of the first year of these changes on patient care, the VA implemented modifications aimed at introducing primary care curricula for training of internal medicine subspecialists, neurologists, and psychiatrists. The change in strategy was in response to the call for better alignment of GME with local patient care and training needs to provide coordinated, continuous care for seriously and chronically ill patients. SETTING: The VA health system, including 172 hospitals, 773 ambulatory and community-based clinics, 206 counseling centers, and 132 nursing homes. PARTICIPANTS: A total of 8900 VA residency training positions affiliated with 107 medical schools. MAIN OUTCOME MEASURE: Proportion of residents in primary care training during the 3-year alignment. RESULTS: Over 3 years, primary care training in the VA increased from 38% to 48% of funded positions. Of this total, 39% of the increase was in internal medicine subspecialties, neurology, and psychiatry. CONCLUSION: In this case study of GME realignment, national policy was driven more by local patient care issues than by a perceived national need for primary care or specialty positions.

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