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The internship: some disquieting findings.

A natural experiment in psychiatric education took place nationally between 1970 and 1976, when one group of residents entered psychiatry with an internship, and the other without one. In this study 22 psychiatry residents with an internship and 25 without one were compared during their first two years of training. Initial faculty evaluations of the two groups' responsibility, insight, teachability, and knowledge were virtually identical, as were those of their overall performance in inpatient, consultation, and emergency psychiatry. However, ratings of outpatient psychotherapy showed several significant and differences favoring the noninternship group. The authors find these results disquieting. They suggest that interferences with empathy may be an untoward side effect of the internship.

Adult↗

The internship year in psychiatry: a status report.

The reinstitution of the "internship" requirement by the American Board of Psychiatry and Neurology resulted in the development of a 4-year residence by most residency programs. The authors distributed a questionnaire to more than 200 psychiatry residency directors to collect data concerning the new "internship" year. Their results indicate that there is considerable diversity in the content of the "internship" and general satisfaction with the quality of the experience.

Attitude of Health Personnel↗

Internship training in psychological assessment: has managed care had an impact?

Training directors of 84 APA-approved internship programs in psychology responded to a survey on the current status and recent changes in internship training in psychological assessment. There appears to be a slight decline in emphasis on assessment in general, although it is still considered to be an important component of training. There was a surprising endorsement of traditional assessment instruments as important for clinical practice, in spite of a trend toward decreased emphasis on projective methods. The majority of programs have maintained the same degree of emphasis on objective measures, intelligence tests, behavioral methods, and the interview, while increasing emphasis on neuropsychological assessment. Less than half (43%) of the training directors reported that their programs have been significantly affected by managed care, suggesting that the majority of internship sites are somewhat insulated from present trends in marketplace pressures regarding reimbursement for psychological testing. The implications of potential future trends are discussed.

Administrative Personnel↗

Cultivating APNs for the future: a hospital-based advanced practice nursing internship program.

This paper describes a clinical nurse specialist/clinical nurse specialist-nurse practitioner (CNS/CNS-NP) internship program in a tertiary care teaching hospital Hamilton Health Sciences, located in south-central Ontario, Canada. The goal of the program is to increase the number of fully qualified CNS/CNS-NPs in the organization. With this program, Hamilton Health Sciences (HHS) is able to recognize and reward nurses already employed within the hospital. The program assists nurses in transition to the CNS/CNS-NP role while they are completing the required educational requirements. The authors describe the components of the internship program, responsibilities of participants and the infrastructure required to support the program. Overall the internship program is a valuable mechanism for supporting the development of advanced practice roles in the hospital setting.

Educational Measurement↗

[Rural internship in dentistry in Rio de Janeiro, Brazil].

This paper describes a rural internship experience developed between 1998 and 1993 by the School of Dentistry, Rio de Janeiro State University. The objective of this program was to raise the social consciousness of undergraduate students. Extramural activities were carried out in the form of supervised 3-month internships in the dentistry services offered by public health units at several locations in the state of Rio de Janeiro. Besides working in the clinics, students took part in activities aimed at assessing oral health in the community, organizational and programmatic structures of the health services, and priorities, appropriate technology, education, and prevention in oral health. These internships integrated the critical thinking of professors, students, class associations, and service-providing institutions regarding the adequacy of education received by future dentists in addressing the true situation of oral health in the state of Rio de Janeiro.

Brazil↗

Selection criteria for APA-accredited internships stratified by type of site and competitiveness.

As the internship marketplace becomes more competitive, doctoral students and faculty of professional psychology programs must become more knowledgeable of the selection criteria used by APA-accredited internship sites. Clinical experience was identified as one of the most important criteria used for selection by all respondents. However, criteria used by medical schools, university counseling centers, and Veterans Affairs Medical Centers, the three largest suppliers of internships, and by sites reporting low, medium, or high competitiveness appeared to vary as a function of the unique characteristics of the sites.

Accreditation↗

What happens to unplaced internship applicants in psychology?

Placement outcomes of students who did not secure internship offers on Uniform Notification Day 1997 were examined. An initial survey of unplaced students (n = 168) suggested mixed outcomes for students in obtaining sites after notification day, including negative emotional effects as a result of nonplacement. A follow-up survey completed by 77 students (43 who had not been placed during the original survey and 34 who had) suggested generally high satisfaction and optimism with internship and employment outlook despite their experiences with the internship application process. Accreditation concerns, emotional, time, and financial expenditures, and potential courses of action are discussed. Concrete suggestions for improving the selection system are provided.

Adult↗

Internships: most and least favored aspects among a business school sample.

This study reports the results of a content analysis involving 143 senior and junior year business school students enrolled in a semester-long internship course for credit (74 males and 69 females). Responses to the question, "What did you like most/least about your internship position?" are reported. Positive aspects of internship are discussed in relation to the Job Characteristics Model.

Adult↗

Nursing internships: taking a second look.

Nursing internships are associated with recruitment and retention efforts of hospitals to gain new nursing employees. They are recognized as a benefit to new nursing staff and the hospital as well. Reported to bridge the gap and ease the transition to registered nurse, internships have been reported in the literature for over 30 years. But how effective are they? This article reviews the recent literature for evidence that internship programs improve recruitment and retention, have a positive cost benefit ratio, and ease the role transition of newly employed nurses.

Clinical Competence↗

A case for more year-long internships outside metropolitan areas?

OBJECTIVE: To determine whether medical graduates who spent their intern year at a non-metropolitan hospital were more likely to practise outside metropolitan areas on completion of training than were interns in metropolitan hospitals. DESIGN: Retrospective follow-up of doctors who held year-long internships at a non-metropolitan hospital and interns from metropolitan hospitals. SETTING: Ballarat Base Hospital (BBH) (Rural, Remote and Metropolitan Area [RRMA] rural zone) and hospitals in Melbourne and Geelong (RRMA metropolitan zone). PARTICIPANTS: 57/63 (90%) Victorian medical graduates completing internships at BBH between 1989 and 1997 and 126/126 (100%) sex-matched metropolitan interns, chosen at random. MAIN OUTCOME MEASURES: Practice location in 2002. RESULTS: More BBH interns were practising as GPs outside metropolitan areas (44%) than metropolitan interns (13%) (difference, 31%; 95% CI, 17%-45%). The proportion of interns in specialist practice outside metropolitan areas was small for both groups - zero and 3%, respectively (difference, - 3%; 95% CI, - 6% to 0). None of the specialist training posts held by interns were outside metropolitan areas. Of BBH interns entering general practice, 41% (95% CI, 24%-58%) did so in the local health region. CONCLUSIONS: Regional interns are a good source of non-metropolitan GPs, especially locally. Prospective studies to determine the precise influence of regional internships on eventual practice location, and whether more such posts would lead to more graduates entering non-metropolitan practice, would be worthwhile.

Family Practice↗

Prediction of graduate dietetic internship appointments in Canada.

A statistical model of dietetic intern selection was developed from a profile of selection criteria that was obtained in a 1988 survey of Canadian graduate dietetic internship directors. The model was composed of four clusters of variables that resulted from the most frequently used selection criteria: academic performance, work experience, communication skills, and extracurricular activities. Data from a convenience sample of 39 dietetic intern applicants were analyzed, using principal components analysis and discriminant analysis, to test the model's power to predict success in obtaining an internship appointment. In descending order, the criteria with the greatest predictive powers were: academic performance; extracurricular activities; and supervisory, teaching, or instructing types of work experience. The model accounted for 41% of the differences between those who were successful and those who were not successful in obtaining internship appointments in 1989 and correctly classified 30 of 39 subjects. These results provide baseline data on the predictive power of some criteria used for selecting dietetic interns. These findings suggest the need for a replication study with a randomized national sample to crossvalidate the results obtained in this exploratory research.

Canada↗

Methodological factors in studying medical graduates: a review of six internship performance studies.

This "state of the art" article examines six internship performance studies of medical school graduates that use rating scales as the vehicle for data collection. The methodological decisions investigators faced in designing the studies are described and the range of options used is illustrated. The content and format of rating forms employed are compared. No methodological standards currently exist for internship performance studies. We call for greater attention to methodological issues in study design, including examination of potential sources of bias. How structural aspects of the internship performance study design may influence the results obtained needs careful study.

Clinical Competence↗

[Self-assessment of clinical skills among medical trainees when entering internship during the spring seasons 1998].

The aim of this study is to identify medical trainees' level of self-reported clinical skills when entering internship. A questionnaire was sent to 124 trainees, who were about to enter their internship. The questionnaire included 88 questions on clinical skills, asking the trainees to rate their level of mastership on a Visual Analogue Scale from zero to ten, 0 = not mastering and 10 = mastering. In total one hundred (81%) returned the questionnaire. There is considerable variation in the self reported acquisition of clinical skills in many of the procedures. In some basic procedures most trainees showed a rather high level of mastership, above 7.5, but in other basic procedures about half of the candidates report a level of mastership below 5.0. A more thorough specification of objectives for practical skills would make it easier to plan an effective and efficient training during internship.

Adult↗

Attitudes of physical therapist students toward physical therapist assistants before and after full-time clinical internships.

Development of attitudes of physical therapists (PTs) toward physical therapist assistants (PTAs) begins during their professional education, and attitudes are influenced further by clinical experiences. The purpose of this study was to understand attitudes of student PTs toward PTAs. We surveyed 66 clinical intern students enrolled in an entry-level master of physical therapy program. PT students received the same survey before and after their full-time clinical internship. Eleven Likert scale items were used to assess students' attitudes toward PTAs in the areas of competence, financial remuneration, and job security. One item was designed to determine whether PT students' level of contact with PTAs influenced attitudes. A random sample of 13 (20.9%) students who returned surveys were asked to participate in a telephone interview designed to enrich the quantitative data. After item analysis, five of the scale items were eliminated from the analyses due to poor internal consistency. Cronbach's alpha of the remaining six scale items was 0.75. Survey results reveal that PT students maintain an overall positive attitude toward PTAs before and after full-time clinical internship. Qualitative interview data support this finding. Students' attitudes in specific areas of PTA competence were negative and positive, however. The negative attitude may have been based on the students' beliefs that PTAs are not competent to perform physical therapy in situations that are changing or unpredictable. Positive attitudes may have been reflective of the students' beliefs that PTAs are competent to implement established plans of care. Student ranking of four professional issues showed a significant difference before and after full-time clinical internships.

Adult↗

Effects of residency training in family medicine v. internship training on professional attitudes and practice patterns.

OBJECTIVES: To determine whether the professional attitudes and practice patterns of physicians with residency training in family medicine differ from those of generalists with internship training. DESIGN: Mail survey conducted in 1985-86. SETTING: Province of Quebec. PARTICIPANTS: A stratified random sample of French-speaking family and general practitioners who graduated after 1972 (325 physicians with residency training and 304 with internship training) (response rate 82%). MAIN RESULTS: Physicians with residency training were 3 years younger on average than those with internship training, were more likely to be female (38% v. 18%, p less than 0.001) and were more likely to work on a salaried basis in CLSCs (public community health centres) (36% v. 14%, p less than 0.001). Even after these confounding factors were controlled for, physicians with residency training seemed to be more sensitive to the psychosocial aspects of patient care and tended to attach more importance to informing patients about useful materials and resources concerning their health problems. They were not, however, more likely to value health counselling or integrate it in medical practice. CONCLUSION: Our findings provide some evidence that the new requirement that physicians complete a residency in family medicine to obtain medical licensure in general practice in Quebec may foster a more patient-centred approach to health care.

Adult↗

[Critical reading ability in research during medical internship].

OBJECTIVE: To evaluate level of development that medical interns achieve, before graduating, in critical reading ability during their internship in five general hospitals. MATERIAL AND METHODS: During the academic year, we compared the initial and final scores of critical reading of medical interns before graduation in five general hospitals in IMSS. An instrument using 98 items that explored interpretation, judgment and proposal was developed and validated by four medical education researchers. In hospitals 1, 4, and 5, professors developed active-participative strategies related to critical reading in clinical research. In Hospital 2, no course was given and in Hospital 3, a traditional course (mainly clinical exposure) was offered. RESULTS: The final global scores were better for those students in Hospitals 1, 4 and 5 versus Hospitals 2 and 3 (median: 31, 29, 31 versus 9 and 24) (Kruskal-Wallis < 0.05). Initial and final differences in global and interpretation, judgment and proposal were also better in those same students. CONCLUSIONS: Active-participative educational strategies may develop the ability for critical reading of clinical research in internship and these strategies must be included in the curriculum during internship.

Biomedical Research↗

Competency development and assessment in undergraduate healthcare management programs: the role of internships.

The profession of healthcare management has come under close scrutiny recently regarding the demonstration of competencies, and increasingly the academic and management literature has advocated for programs in healthcare management to address competency development. This paper addresses the importance of developing and assessing competencies, using undergraduate programs as its focus. Using an expanded framework suggested by the literature, this paper discusses competencies that are demonstrated through a required internship program at an undergraduate healthcare management program. Findings suggest that technical skills, conceptual skills, interpersonal skills, and personal growth and development are all important domains for competency attainment through internships. The approach offered is helpful to undergraduate programs as they address the role of internships in competency development and assessment.

Competency-Based Education↗

Evaluation of a predoctoral clinical psychology internship program by intern graduates.

This investigation is a replication and extension of an earlier study by Stout, Holmes, and Rothstein (1977) of the predoctoral clinical psychology intern graduates at the William S. Hall Psychiatric Institute. The interns were surveyed (N = 63) with regard to how adequately their internship experience prepared them for their current professional work as practicing clinical psychologists. Questionnaire data (n = 44) from graduates are analyzed in terms of the demographics of each intern's work situation, ratings of how well their internship prepared them in the areas of interprofessional relationships, teaching psychodiagnostic evaluations, psychological treatment, administration, consultation, and research. Several recommendations are offered by the intern graduates for refinement of the clinical psychology internship.

Adult↗