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PubMed2005

Faculty internships in environmental health: planning and implementation.

Faculty internships, in which a faculty member works temporarily for a government organization or a private business, are a concept that is becoming popular at universities. This paper discusses how a faculty internship can be developed and implemented, and it reports on the advantages of the internship for academia, the sponsoring institution, and the professor. In addition, suggestions on structuring and implementing the internship are offered. The major objective of the paper is to encourage environmental health educators to seriously consider faculty internships as a means of bridging the gaps between academia and the business world. Faculty internships should be beneficial primarily for two groups of professors. First are those professors who, after earning doctorates, enter the teaching profession without any environmental health practicum experience. Second are those who once worked full time as environmental health practitioners but have been out of the field for a significant number of years with little or no contact with the "real world" of environmental health practice. The information presented is based on the experience of the author, who served as a faculty intern for the environmental health division of a county health department in rural west-central Indiana, Some of the benefits of faculty internships are improved teaching methods, practical experience, community contacts, and increased internship opportunities for students. The experience can enhance classroom theory for students, and the implementation of practice can be clarified for the educator.

Commerce↗

PubMed1990

Nutrition education and counseling: knowledge and skill levels expected by dietetic internship directors.

Development of nutrition education and counseling skills is important in the educational preparation of dietitians. A national survey of dietetic internship directors was conducted to determine competency levels expected of students at the start of an internship, internship training given, and further preparation students need in 32 knowledge/skills areas deemed essential for delivery of nutrition education and counseling services. Completed questionnaires were received from 66 of 102 (65%) internship directors surveyed. The majority of directors expected only basic preparation for group nutrition education and individual counseling knowledge/skills areas. Internship training in nutrition education competencies was "moderate" to "extensive," whereas preparation in nutrition counseling competencies was more likely to be "extensive." Directors perceived the internship to provide adequate preparation in all but the advanced practice skills, such as behavior modification and motivational strategies, for which further preparation was recommended. The majority of internship directors reported that more than 25% of the intern practice experience was in patient counseling, with less experience in group instruction. Implications for undergraduate dietetic education are discussed in relation to internship directors' expectations as well as to present and future trends in the dietetic profession.

Counseling↗

PubMed1985

Reintroducing the internship: reactions of three departments of psychiatry.

The reintroduction of the internship requirement has caused a number of changes in psychiatric education in the past decade. Many psychiatric educators and departments of psychiatry have been faced with the challenges of organizing internships and establishing an internship curriculum. This has been especially challenging because the psychiatrists involved have seldom had full postgraduate training in the fields being organized and have not previously administrated clinical services in those areas. The authors discuss the goals of the internship for future psychiatrists and the pros and cons of university versus community general hospital based internships for future psychiatrists, and find several potential advantages to the latter. Also discussed are their consistent observations of internship programs for future psychiatrists over the past decade in three geographically separate regions and in state and private institutions. They and most other faculty members in their respective departments believe that the reinstitution of the internship has had largely beneficial effects on future psychiatrists.

Hospitals, Community↗

PubMed1993

Relationships of interns' performances to their self-assessments of their preparedness for internship and to their academic performances in medical school.

This study addressed the questions of whether medical students' cumulative grade-point averages (GPAs) correlate with the performance assessments (overall and in specific areas of competency) that they receive as interns from their internship program directors, and whether the students' self-assessments of preparedness for internship correlate with their internship directors' overall assessments. A questionnaire to assess interns' competencies was developed and sent to the directors of the internship programs of the 283 1990 and 1991 graduates of the Medical College of Georgia School of Medicine who consented to participate in the study (82% of the graduates). Eighty percent of the program directors responded. A similar questionnaire was sent to all 342 of the 1990 and 1991 graduates; 38% provided self-assessments of their competencies and also stated their views on how well prepared they were for their internships. Considering the classes as a group, the mean ratings of the interns' overall competencies by the program directors ranged from 3.7 to 4.3 on a five-point Likert scale (1, unsatisfactory, to 5, outstanding), whereas the interns' ratings of how well they were prepared for their internships (that is, their sense of overall competency) were somewhat lower, ranging from 3.4 to 4.0. The correlations of GPAs with the specific areas of competencies ranged from .28 to .51. The correlation between the mean ratings of the program directors and the mean self-ratings of the interns was .58. The data support the conclusions that medical school academic performance relates significantly to performance in internship and that interns do not rate themselves as highly as their program directors do.

Achievement↗

PubMed2002

Internship placement data: is nonplacement the only concern?

Current discussion regarding securing internships often focuses on their availability. Thus, quantity is especially emphasized. However, quality is also an issue of importance. The number of intern applicants receiving slots at quality internship sites, as defined by the internship having been accredited by the American Psychological Association or having successfully been reviewed by the Association of Psychology and Postdoctoral Internship Centers, was assessed. Information regarding the number of unfunded internships also was gathered. Recommendations for increasing the availability of quality internships are provided.

Accreditation↗

PubMed2005

[Logistical regression of success factors in the former internship examination for medical students].

INTRODUCTION: The French competitive internship examination for medical students was replaced in 2004 by a national-ranking exam. The profile of students successful at the internship exam, although more or less stereotypical, was never methodically analyzed. AIMS: To determine the factors that influenced success in the internship exam. METHODS: Records of 242 students from four successive entering classes (1989-1992) at the Saint-Etienne Faculty of Medicine underwent logistical regression analysis. Factors studied were: gender; occupation of the head of household; details about their General Certificate of Education test (age attest, core subject, overall grade); repeating any first-cycle medical studies (PCEM1); PCEM1 grade; number of certificates resat at the end-of-year make-up session or the following year during second-cycle medical studies (DCEM), known as "debts"; and the ranking obtained in the five faculty certificate tests deemed representative of the overall competitive test and on the clinical and therapeutic summary certificate (CSCT). RESULTS: The 95 students (59%) who did not take the internship exam differed from those who did. The former typically: (1) were older when they began studying medicine (p = 0.003); (2) had passed the General Certificate of Education with the lowest or next lowest pass levels (p = 0.023); (3) re-did their PCEM1 studies (p = 0.001); (4) were ranked in the lower two-thirds of their PCEM1 class (p = 0.001); (5) had more PCEM1 certificates to resit during DCEM (p = 0.007); (6) were ranked in the lower two-thirds of their class for the certificates (including the CSCT) (p < 0.001). Of the 147 students who did take the internship exam, 102 (69%) passed. Logistical regression identified three predictive factors in their success: (1) took the General Certificate of Education at an average or younger than average age (adjusted odds ratio (OR) 7.79, confidence interval (CI) 95% [1.59-38.13]); (2) had at most one "debt" (adjusted OR 16.51 [1.88-144.78); (3) ranked in the top third of their class for certificates (including the CSCT) (adjusted OR 7.84 [2.42-25.41]). CONCLUSION: Our study objectively confirmed that consistent work and effective learning strategies, acquired early during education and applied throughout medical studies, strongly promoted success in the previous internship exam. It is likely--but should be verified--that medical students who choose this strategy of constant effort will also do best on the new national-ranking examination.

Educational Measurement↗

PubMed2006

Disentangling clinical learning experiences: an exploratory study on the dynamic tensions in internship.

Clinical practice is an essential component of medical training, but not all internships yield the appropriate and expected learning results. We report on an exploratory study of the learning process during internship in undergraduate medical education. We hypothesised that learning experiences in clinical practice are determined by characteristics of the interns, characteristics of the training setting and the meaningful interactions between them. As the study focused on the perceptions and interpretations of both interns and their supervisors of interns' experiences in practical training, qualitative research methods were used for data collection and analysis. This consisted of student shadowing, complemented by informal and semistructured interviews with both interns and supervisors. Analysis revealed 5 components that constitute learning experiences in clinical internship. These components represent dynamics in the clinical environment that constantly require students to (re-)define and (re-)position themselves: the agenda of the internship (working versus learning); the attitude of the supervisor (evaluator versus coach); the culture of the training setting (work-orientated versus training-orientated); the intern's learning attitude (passive versus proactive), and the nature of the learning process (informal versus formal). The model of components and tensions offers a conceptual framework to analyse and understand students' learning during internship. It not only contributes to a grounded theoretical conceptualisation of clinical learning, but may also be used in efforts to improve the quality of learning during internship, as well as the level of support and supervision.

Attitude of Health Personnel↗

PubMed2001

Psychological assessment on internship: a survey of training directors and their expectations for students.

We used a survey of internship training directors to examine the nature of assessment use and assessment skills training at 382 internship settings in professional psychology across the United States and Canada. For the purposes of this study, we created a questionnaire that inquired about the types of assessment instruments used at each internship setting, the amount and type of training offered at internship sites, and the type of assessment experience desired of interns before beginning their rotations. The results revealed several differences across type of internship facility surveyed as well as several trends in the current use of assessment in applied settings. The findings further demonstrate the important role of projective assessment in the training of graduate students and lead to the conclusion that major discrepancies may exist between what is being taught in graduate school and what students are expected to know on entering their internship positions.

Canada↗

PubMed2003

Dietetic internship forum--an opportunity to inform.

Each year in Atlantic Canada, a dietetic internship forum is held to inform potential dietetic interns of internship opportunities. This paper provides information to those planning similar events, and seeks to enhance knowledge of students' information-seeking strategies in the internship selection process. The objectives of this study were to 1. profile students who attended the 2000 forum, 2. determine their intentions, 3. determine how--and if--the forum influenced internship selection, and 4. determine overall satisfaction with the forum. A 23-item questionnaire was used to collect data from 52 forum participants (100% completion rate). Results indicated overall satisfaction with the forum. Prospective interns seek, use, and value information about potential training choices, particularly when that information concerns programs outside the Atlantic region. Participants indicated that the forum helped confirm or alter pre-forum perceptions of their first and second internship choices. The results suggest that alternative types of presentations, which would include out-of-region internship opportunities, should be explored to meet students' needs for information better.

Canada↗

PubMed2004

[50th anniversary--cheers to the internship?].

This year the mandatory internship scheme for Norwegian doctors celebrates its 50th anniversary. Internships were instituted by a Decree in Council in 1954 and implemented the year after. History shows that there has been and still is a lack of commitment to the organisation as well as the content of internships. It also shows that there has been a lack of adequately formulated objectives and how detrimental this state of affairs is to the educational quality of internships. Today we face threats that the scheme may be abolished altogether. Among the reasons for this is a lack of commitment among senior doctors to supervision and mentoring, inadequate funding and, probably the most important single reason, a lack of thorough evaluation of the existent scheme. New models for internship content have been proposed by the medical authorities, but in the view of the Norwegian Medical Association the existent model should be evaluated before new models are tried out. This article shows what an important asset the internship scheme is and the necessity of arguing for keeping it.

Foreign Medical Graduates↗

PubMed1991

Selection criteria for approved preprofessional practice programs: are they different from those for dietetic internships?

Using a mailed questionnaire, we surveyed the directors of 41 approved preprofessional practice programs (AP4) listed in the Directory of Dietetic Programs 1990 and nine programs approved by The American Dietetic Association's Council on Education in December 1989 to determine the relative importance of admission criteria used to select students for AP4s. We compared the results of this study with those of an earlier survey of dietetic internship directors. The AP4 and dietetic internship directors gave significantly different importance ratings to elective courses in professional sciences and courses in the biological/physical sciences. Unlike dietetic internship directors, AP4 directors rated Graduate Record Examination (GRE) score highest (1.4 +/- 1.7 on a 10-point scale). AP4 directors' rating of grade point average (1.8 +/- 1.3) and professional courses (1.9 +/- 1.2) was similar to the internship directors' rating of these criteria (1.7 +/- 0.9 and 1.7 +/- 1.0, respectively). Results indicate that AP4 and internship directors seek similar qualities in students, but that GRE score is more important to AP4 directors. The AP4 directors' emphasis on GRE score may be explained, in part, by the fact that 76% (38 of 50) of these programs are affiliated with a university program, and of those 38 programs, 29 (88%) require graduate credit as a component of the AP4. These data are important to Plan IV/V faculty advisers because students may have misconceptions about differences in AP4 and internship selection criteria.

Dietetics↗

PubMed1987

Perceptions of competency attainment in community dietetics: academic Plan IV vs. dietetic internship.

A national survey of Plan IV representatives, internship directors, and dietetic interns was conducted to determine the perceived level of competence in community dietetics upon completion of academic coursework. Interns also rated their perceived competence in community dietetics near the end of internships. All major and specific responsibilities from the ADA Role Delineation and Verification for Entry-Level Positions in Community Dietetics were included in the survey questionnaire. Completed questionnaires were received from 447 dietetic interns (60%), 47 internship directors (57%), and 59 Plan IV representatives (39%). Highly significant differences were found among the three groups, with Plan IV representatives' expectations highest and students' lowest. Work experience prior to internship affected mean ratings on selected responsibilities. Unlike the results of the previous studies in clinical dietetics and foodservice systems management, the ratings in community dietetics did not reach their highest until the last month of the internship. Findings from all three areas of dietetic practice suggest that students' perceived competence is considerably lower upon completion of Plan IV than after completion of an internship, indicating need for defined work experience. Different teaching techniques, i.e., lecture vs. hands-on, could be related to different ratings of perceived competence within and between practice areas.

Competency-Based Education↗

PubMed1986

Perception of competency attainment in foodservice management: academic Plan IV vs. dietetic internship.

A national survey of 487 dietetic interns (61%), 63 internship directors (76%), and 68 Plan IV representatives (45%) utilized ADA entry-level role responsibilities in foodservice systems management. Student respondents rated perceived competence at the start and near completion of the internship. Program directors rated expected competence at the start of the internship. The three groups differed significantly on mean responses, with interns' ratings lowest and Plan IV representatives' ratings highest. Interns' mean ratings suggested that work experience just prior to starting an internship increased competence somewhat, regardless of type of work. Work during college was not included in the analysis. Interns' mean ratings also suggested that competence peaked some weeks before internship completion. Level of competence averaged about 6 on a scale of 0 to 7 at that time. Starting competence averaged about 2.5 to 3, indicating that Plan IV contribution is substantial but internship experience is essential for entry-level performance. Foodservice systems management competence levels compare very favorably with those previously reported for clinical dietetics.

Dietetics↗

PubMed2006

Internship workplace preferences of final-year medical students at Zagreb University Medical School, Croatia: all roads lead to Zagreb.

BACKGROUND: Human resources management in health often encounters problems related to workforce geographical distribution. The aim of this study was to investigate the internship workplace preferences of final-year medical students and the reasons associated with their choices. METHOD: A total of 204 out of 240 final-year medical students at Zagreb University Medical School, Croatia, were surveyed a few months before graduation. We collected data on each student's background, workplace preference, academic performance and emigration preferences. Logistic regression was used to analyse the factors underlying internship workplace preference, classified into two categories: Zagreb versus other areas. RESULTS: Only 39 respondents (19.1%) wanted to obtain internships outside Zagreb, the Croatian capital. Gender and age were not significantly associated with internship workplace preference. A single predictor variable significantly contributed to the logistic regression model: students who believed they would not get the desired specialty more often chose Zagreb as a preferred internship workplace (odds ratio 0.32, 95% CI 0.12-0.86). CONCLUSION: A strong preference for Zagreb as an internship workplace was recorded. Uncertainty about getting the desired specialty was associated with choosing Zagreb as a workplace, possibly due to more extensive and diverse job opportunities.

Journal Article↗

PubMed1998

Learning, satisfaction, and mistreatment during medical internship: a national survey of working conditions.

CONTEXT: Concerns about the working and learning environment of residency training continue to surface. Previous surveys of residents have focused on work hours and income, but have shed little light on how residents view their training experience. OBJECTIVE: To provide a description of the internship year as seen by a large cross section of second-year residents. DESIGN: Mail survey conducted in 1991. SETTING: Residency programs in the United States. PARTICIPANTS: Random 10% sample (N=1773) of all second-year residents listed in the American Medical Association's medical research and information database. MAIN OUTCOME MEASURES: What and who contributes most to residents' learning during internships, degree of satisfaction with the internship experience, on-call and sleep schedules, incidents of perceived mistreatment or abuse, observations of unethical behavior, and experiences of harassment or discrimination. RESULTS: A total of 1277 surveys (72%) of 1773 mailed were returned. Overall, respondents reported a moderate level of satisfaction with their first year of residency. On a scale of 0 to 3, residents rated other residents as contributing most (score of 2.3) to their learning, with special patients ranked second (2.1). During a typical work week, residents reported that they spent an average of 56.9 hours on call in the hospital. A total of 1185 (93%) residents reported experiencing at least 1 incident of perceived mistreatment, with 53% reporting being belittled or humiliated by more senior residents. Among women residents, 63% reported having experienced at least 1 episode of sexual harassment or discrimination. A total of 45% of residents reported having observed another individual falsifying medical records, and 70% saw a colleague working in an impaired condition, most often lack of sleep. Regression analyses suggest that satisfaction with the residency experience was associated with the presence of factors that enhanced learning, and fewer experiences of perceived mistreatment. CONCLUSIONS: Residents report significant problems during their internship experience. Satisfaction with internship is enhanced by positive learning experiences and lack of mistreatment.

Attitude of Health Personnel↗

PubMed1985

Biofeedback training: offerings, plans, and some attitudes in graduate schools and internships.

Graduate schools and APA-approved internships in North America were surveyed to determine the type and extent of biofeedback training, additional biofeedback training planned, requirements considered to be a minimum necessary before beginning clinical practice of biofeedback, when biofeedback is considered an appropriate application, and whether biofeedback is considered a "passing fad" in clinical practice. Questionnaires were returned by 56% of the graduate schools and 54% of the internships, and revealed training in 58% and 67% respectively. Training in biofeedback procedures appears to be growing, and most graduate schools and internships think that biofeedback is not a passing fad in clinical practice. Training emphases vary considerably across graduate schools and internships, with some schools and internships excluding theory and/or practice and/or research from their instruction. The results are discussed in relation to the question of determining which procedures to include in future instruction.

Attitude↗

PubMed1988

The doctor-patient relationship during medical internship: the evolution of dissatisfaction.

We prospectively examined perceptions of the doctor-patient relationship among interns in two different internal medicine training programs five times during the internship year. All 59 interns in the University of California, Irvine-Long Beach and the Oregon Health Sciences University Medical Programs participated in the study during the 1982-83 internship year. We serially administered a questionnaire that contained four major items: (1) a choice of one of six empirically developed role paradigms of the doctor-patient relationship; (2) a checklist of positive and negative aspects of internship; (3) a measure of level of satisfaction with the decision to become a physician; and (4) a rating list of mood descriptors. The six role paradigms portrayed a variety of positive and negative aspects of the doctor-patient relationship. At the beginning of the year, the interns were quite positive about the doctor-patient relationship and preferentially endorsed collegial models. As the year progressed, they endorsed significantly fewer positive and more negative models (P less than 0.001). Most respondents endorsed two models, one positive: "expert resource (doctor)--active cooperative participant (patient)" and one negative: "clerk, paperwork processor (doctor)--subscriber, seeker of eligibility (patient)." By the end of the year approximately half of the interns endorsed a positive and half a negative model. Interns selecting a negative model of the doctor-patient relationship identified more negative and fewer positive aspects of internship than those selecting a positive model. Specifically, they significantly more often (P less than 0.001) identified too much paper work and coping with difficult patients as negative aspects of internship.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1996

Benefits of training dietetics students in preprofessional practice programs: a comparison with dietetic internships.

OBJECTIVE: To conduct a nationwide study on the opinions of dietitian preceptors regarding the intangible benefits to hospitals and medical centers of training dietetics students in approved preprofessional practice programs (AP4s) and to compare the findings with a similar survey of dietetic internships. DESIGN: A questionnaire was adapted from a 1990 study of preceptors in dietetic internships to investigate the benefits of training dietetics students in AP4s. SAMPLE: Program directors and dietitians who supervise and teach students in the 117 preprofessional programs approved by The American Dietetic Association were sent pretested questionnaires. Responses to the survey were received from 312 dietitians who supervise students in 74 practice programs. STATISTICAL ANALYSIS: Descriptive statistics were used to calculate frequency of response. t Tests were used to compare mean differences between the opinions of preceptors in AP4s and internships. Analysis of variance and Scheffe post-hoc test were used to determine the demographic characteristics related to the dietitians' opinions of benefits. RESULTS: Strongest agreement (agree to strongly agree) was found for three items: sense of satisfaction from seeing students develop as professionals (4.34); belief that teaching students makes the job more interesting (4.17); and real sense of achievement in working with students (4.05). Significant differences were found between the groups on six items and, in all but one instance, the internship preceptors were more in agreement with the statements on intangible benefits than the AP4 preceptors. APPLICATIONS/CONCLUSIONS: The preceptors generally agreed that intangible benefits exist for departments that are AP4 sites and the professionals that work in them. As programs develop from AP4s into accredited internships, examination of intangible and monetary benefits may affect the continuation of dietetics training programs.

Cost-Benefit Analysis↗