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PubMed2004

Need for strengthening of internship (rotatory housemanship) training in India.

INTRODUCTION: Internship is a problematic phase in the training of doctors in India. At the end of their one-year Internship, students are not formally examined for proficiency, rarely a student is not given a satisfactory completion certificate and training is sometimes not supervised. Students are required to spend three months of this Internship in Primary Health Centres at rural postings. During this period the students often prepare for the written exams that would allow them to pursue post-graduate studies. METHOD: In a personal reflection, this situation is described in the current article. The author suggests several approaches to improve this unwanted situation, so that the rural postings could be taken more seriously by the students. OUTCOMES: Suggestions range from a post-internship examination, via the introduction of compulsory rural postings after graduation to an increase of the avenues for post-graduate training to include a course in family medicine and general practice. CONCLUSIONS: The objective of providing excellent training during internship periods cannot be achieved unless interns actively participate. If the current situation does not change, for example according to the suggested solutions, this valuable component of medical training will remain problematic, thereby hindering the optimal preparation of doctors for the entire spectrum of necessary health care in India.

Clinical Competence↗

PubMed2002

A macro perspective of non-clinical student internship programs.

Internships are advantageous to both health care organizations and students. Intern employers benefit in many ways such as completing meaningful backlogged projects, savings on benefits, using internships as a recruiting tool, and becoming a partner in the educational process. There are drawbacks to internships such as increased managerial time to supervise interns and monitor projects, contingent workforce issues with which to deal, and assignment of routine tasks only. Indicators for administration of meaningful internship programs as well as evaluation concerns are discussed. This article addresses college and university internships excluding applied health care clinical rotations.

Health Facility Administration↗

PubMed2000

Internship training in marriage and family therapy: a survey of doctoral program objectives and implementation.

This article presents the results of a survey that examined the implementation of the Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE) internship requirement by accredited doctoral Marriage and Family Therapy (MFT) programs. Representatives from each of 10 doctoral MFT programs provided responses to questions regarding program objectives for internship training. Respondents also provided subjective impressions regarding the effectiveness with which established internship goals are accomplished, associated benefits and difficulties, and adequacy of the standards. Results suggest that although most programs perceive the internship requirement as beneficial, many express concern regarding the effects of the internship requirement on other aspects of training and in relationship to the overall goals for doctoral MFT education. Conclusions and recommendations are offered based on the mixed findings.

Curriculum↗

PubMed1990

[Effect of internship on the Israeli medical graduate].

We interviewed medical school graduates, both prior to and on completion of their year of internship, to assess what impact it had had on their choice of career and to judge whether or not their expectations for their internship had been fulfilled. 25% of the graduates had been unsure of their residency plans before starting internship, while only 13.7% were unsure at the end. Surgery proved to be the most popular field, with 30% choosing it before the internship and 34% at the end. Initially, 72% of the graduates wanted to go abroad to specialize, but only 42% at the end of the year, and only 20% actively explored the option. The internship is an important aid for clarifying professional goals and bridging the gap between the medical graduate's expectations and the realities of medical practice.

Career Choice↗

PubMed1982

Student selection in dietetic internship programs.

Recent events mandate that internship faculties review their selection criteria and processes carefully. These events include legal decisions and the implementation of federal regulations, as well as the dietetic traineeship "phase-out" and ADA's decision to rescind application restrictions. This study profiles the 1978 selection criteria and processes used by 47 of the 68 accredited dietetic internship programs. The most common criteria included (in decreasing order of importance): academic records, letters of recommendation, applicant essays, and demographic/biographic data. Standardized tests and applicant interviews were used infrequently. The reliability and validity of certain selection criteria, e.g., letters of recommendation, are questioned. Recommendation for increasing the predictive quality of the letters and other selection tools are included. Criteria of questionable legality should be reviewed and clarified or eliminated from selection processes. Finally, internship directors are encouraged to evaluate their selection processes to assure objectivity and sensitivity. The authors found that the selection criteria used by internship programs corresponded to those used by most academic and allied health professions to predict success in the programs. Although intended for internship faculties, the recommendations may be useful to coordinated undergraduate dietetics programs as they define their selection criteria.

Dietetics↗

PubMed1988

A neurosciences internship and graduate nurse role conception.

Registered nurse (RN) turnover is a severe problem many hospitals face in today's health care climate. A study was conducted of a graduate nurse (GN) neurosciences internship established in a large metropolitan teaching hospital located in southwestern Tennessee to determine the internship's effect upon role conception of GNs. Thirty-two GNs enrolled in the internship comprised the experimental group, and 22 GNs in traditional orientation were the control group. Data collection instruments consisted of Corwin's Role Conception tool and a demographic questionnaire designed to examine variables that could influence professional role conception. Both instruments were completed at the beginning of employment, and Corwin's Role Conception repeated after completion of the first six months of practice. At this time audiotaped interviews were conducted by a nurse counselor to collect qualitative data from ten randomly selected informants from each group. Results revealed no significant differences in the two groups regarding changes in role conception as measured by Corwin's instrument. Audiotaped interviews brought to light many concerns of new GNs with regard to inadequate staffing, the charge nurse role, coping with the stress of the professional nurse role and new attitudes toward the field of the neurosciences. Implications for nurse administrators include the need to: be aware of the stresses to which new GNs are exposed; examine traditional practices such as the charge nurse role and staffing patterns; determine whether nursing internships, such as the neurosciences internship can improve the attitudes of GNs toward their specialty.

Adult↗

PubMed2007

The development of physician confidence during surgical and medical internship.

BACKGROUND: While much research has addressed physician competency, the development of confidence has not been studied. We sought to identify which elements of internship residents feel most contributed to building their confidence. METHODS: By anonymous survey, University of Pennsylvania residents rated 104 internship elements for contribution to building physician confidence and reported their subjective confidence during and since internship. RESULTS: Two hundred ten residents in 18 specialties participated. Detailed ratings for all 104 elements are provided. Generally, independent decision-making items and good back-up support were equally highly valued, as was developing work efficiency. Poorly valued items included high patient loads, long hours, and abusive interactions. Surgical and medical residents agreed. Mean confidence increased during internship from 12 to 32 (1-100 scale) but remained in the 50s during residency for most specialties. CONCLUSIONS: Faculty should make informed, deliberate attempts to provide those elements identified as most fostering the development of physician confidence.

Attitude of Health Personnel↗

PubMedDate not supplied

Senior medical student "Boot Camp": can result in increased self-confidence before starting surgery internships.

OBJECTIVE: Surgical residents often begin the internship without prerequisite skills necessary for appropriate patient care. The purpose of this study was to develop a surgical internship readiness elective or senior medical student (SMS) "Boot Camp" for fourth-year medical students to prepare them for the rigors of surgery internship. DESIGN: Sixteen fourth-year medical students completed a series of clinical and didactic sessions over a 4-week elective. Students evaluated the effectiveness of the elective with a pre- and post-survey that focused on confidence levels in 4 areas: anatomic dissection, administrative skills, technical skills, and patient management. Students also participated in a focus group session that identified strengths and weaknesses of the elective. Students were also assessed on performance by anesthesiology faculty in the mock patient code and by nursing faculty in mock nursing page sessions. RESULTS: Upon completion of the elective, students rated themselves as more confident in all 57 categories on the survey. During the focus group session, students identified several strengths of the elective and offered recommendations for improvements in the elective. CONCLUSION: The SMS "Boot Camp" gave fourth-year medical students confidence and an opportunity to develop necessary prerequisite skills to begin the surgery internship.

Adult↗

PubMed2003

A preceptor focus group approach to evaluation of a dietetic internship.

Geographical dispersion of preceptors within dietetic internship programs creates educational challenges. Iowa State University's dietetic internship utilizes preceptors from more than 90 facilities statewide. Three preceptor focus groups were conducted to identify strengths and areas needing improvement in the internship, including preceptor and intern needs and expectations. Of the more than 90 preceptors representing medical nutrition therapy, foodservice management, and community nutrition, 36 were contacted and 18 preceptors participated, resulting in 5 to 7 participants per focus group. Emerging themes included effective feedback; preceptor networking; and communication between internship program/faculty, interns, and preceptors. Geographic isolation and minimal use of Internet-based resources may contribute to these themes. Whereas the majority of preceptors had access to the Internet, only 7 (38%) had accessed the Internet-based resources provided by the program. Preceptor suggestions can provide new perspectives for enhancing the learning environment. Regional workshops and e-mail list-serves can help facilitate communication and networking among preceptors.

Communication↗

PubMed2005

The relative importance of individual and organizational factors for the prevention of job stress during internship: a nationwide and prospective study.

This study aimed to investigate the relative and sequential importance of individual and organizational predictors of job stress associated with medical internship work. All medical students who graduated in Norway over 2 years (n = 631) were surveyed and followed up 1 year later at the end of the hospital internship year. The outcome was job stress as a house officer; predictor variables included individual factors at medical school and work-related factors during internship. A total of 371 (58%) responded at both time points. Adjusted predictors of job stress were: vulnerability (neuroticism) personality trait (beta 1.7 [95% CI, 0.94 to 2.5]); perceived recording skills (beta -0.43 [-0.78 to -0.08]); number of hours of sleep when on call (beta -2.3 [-3.6 to -1.0]); and learning environment on the hospital wards (beta -0.56 [-0.82 to -0.30]) (see table 2). The vulnerability trait was especially important among the female interns. The predictors explained 29% of the total variance in the model; personality contributed 16% of the variance, perceived recording skills 4% and the organizational factors measured in the internship year explained 9%. In terms of prevention, both individual factors (personality trait and perceived skills) and organizational work-related factors (sleep deprivation and learning environment on the wards) should be considered.

Adult↗

PubMed2003

Does the osteopathic internship have a future?

Since 1984, a new set of realities has generated pressures that are transforming osteopathic graduate medical education (OGME) and forcing it to adapt to changing circumstances. Policy decisions were made that addressed these circumstances, and the impact of these choices moved OGME in new directions. Many of the changes were perceived as positive, but inherent weaknesses were exposed as well. While the appearance and structure of OGME have been significantly altered, nowhere are the changes more apparent than in the traditional osteopathic internship. Compared with 1990, today's osteopathic internship is markedly different in terms of its curriculum, its identity, and its place within residencies approved by the Accreditation Council for Graduate Medical Education. As a direct consequence of decisions made to expand internship opportunities, the traditional osteopathic internship appears destined to vanish as a distinct educational experience.

Education, Medical↗

PubMed1981

Notes on a medical internship.

Though much is currently written about the fate of the medical internship, only one previous study detailing the specifics of the internship experience has been recorded in the literature. The present report summarizes a straight medical internship in a university training program. There were 329 admissions in 123 admitting days. A large variety of medical problems were encountered and a high percentage of patients were acutely ill. Heart disease and cancer accounted for 40% of all admissions and nearly half of all deaths. The most frequently performed procedure was lumbar puncture. It is hoped that this report will stimulate objective record-keeping by others, so that future discussions about the medical internship will be based on fact and not impression.

Hospitals, Teaching↗

PubMed2006

Preparing fourth-year medical students to teach during internship.

Interns are expected to teach medical students, yet there is little formal training in medical school to prepare them for this role. To enhance the teaching skills of our graduating students we initiated a 4-hour "teaching to teach" course as part of the end of the fourth-year curriculum. Course evaluations demonstrate that students strongly support this program (overall ratings 2000 to 2005: mean=4.4 [scale 1 to 5], n=224). When 2004 course participants were surveyed during the last month of their internship, 84%"agree" or "strongly agree" with the statement: "The teaching to teach course helped prepare me for my role as a teacher during internship" (2005: mean 4.2 [scale 1 to 5], n=45, response rate 60%). A course preparing fourth-year students to teach during internship is both feasible and reproducible, with a minimal commitment of faculty and resident time. Participants identify it as an important addition to their education and as useful during internship.

Curriculum↗

PubMed1999

A family therapy internship in a multidisciplinary healthcare setting: trainees' and supervisor's reflections.

Family therapy doctoral students from American Association for Marriage and Family Therapy-accredited programs are required to complete a full-time clinical internship. The literature provides little information about these internship experiences. Two doctoral-level marriage and family therapists summarize their professional and personal experiences in their internships located within a multidisciplinary healthcare setting. In addition, their supervisor reports on her experiences working with marriage and family therapy doctoral interns. We hope that this case report will stimulate all interns and their supervisors to provide feedback to their internship sites and graduate programs about their clinical training and the extent to which the programs prepared them for their marriage and family therapy careers in the larger health and mental health community.

Adult↗

PubMed1978

The internship year: a negative view.

The decision to add a fourth year of training with emphasis on a primary care internship experience has created serious problems for most psychiatric residency training programs. The logistic problems involved in having a department of psychiatry develop an internship program are formidable. The experiences being provided are less than optimum. Conceivably, the logistic and quality uncertainties that now characterize some PGY-I programs may be a factor in discouraging medical graduates from entering psychiatry. The reasons for moving to an internship experience are also questionable. There are no data which suggest that the new training will produce better psychiatrists. Nor can the case for the internship be supported by past experience or an analysis of the educational needs of today's psychiatrist. Dr. John Romano comments on the author's presentation.

Internship and Residency↗

PubMed2003

The loss of idealism throughout internship.

The purpose of this project was to understand how resident attitudes to specific types of patients change throughout their internship. Over a 3-year period all 1st-year internal medicine residents were asked to complete a 15-item survey regarding their attitudes toward certain patient types and the profession. The survey was administered the 1st day of the internship, again in mid-November, and in June in the last month of internship. Sixty-one of 80 interns (76% response) completed all three administrations of the survey. In general, there were statistically significant differences in attitudes from the first administration to the second in all categories (all changes reflecting less idealism), with attitudes remaining the same for the second to third administration. For example, interns believed significantly more patients requesting narcotics were drug seekers (19% vs. 33%/37%, p < .0001) and a lesser percentage of the elderly could care for themselves independently (62% vs. 50%/48%, p < .0001). We conclude interns become less idealistic toward patients and the profession throughout internship, with the greatest change within the first 5 months.

Affect↗

PubMed2003

Emotional intelligence and perceived employability for internship curriculum.

Emotional Intelligence dimensions of motivation as well as social and communication skills were associated with perceived entry-level employability. Feedback from internship hosts was the measure of association for 77 college juniors or seniors between the ages of 18 and 22 (49 women, 28 men), enrolled in a one-semester communications internship. Chi squared supported the hypothesis that interns scoring high on emotional intelligence are more likely to be considered for employment by the internship host than those scoring low. Given replication of this work applications for an internship curriculum can be identified.

Adolescent↗

PubMed1999

Library residencies and internships as indicators of success: evidence from three programs.

This paper discusses post-master's degree internships in three very different organizations; the University of Illinois at Chicago, the National Library of Medicine, and the Library of Congress. It discusses the internships using several questions. Do the programs serve as a recruitment strategy? Do the programs develop key competencies needed by the participant or organization? Do the programs develop leaders and managers? Is acceptance into a program an indicator of future career success? A survey was mailed to 520 persons who had completed internships in one of the three programs. There was a 49.8% response rate. Responses to fifty-four questions were tabulated and analyzed for each program and for the total group. The results confirm the value of internships to the career of participants.

Adult↗