The clinical task force: Improving quality of medical students' internship.

Background: Up to 40% of young medical doctors feel that the internships prepared them insufficiently for the clinical work. This study investigated whether a Clinical Task Force (CTF) could improve internship quality. Methods: The CTF visited internship departments with a triple-targeted approach: first, departments pre-filled a self-evaluating questionnaire; secondly, CTF visited departments to discuss the self-evaluation and previous student evaluations; and thirdly, CTF and departments agreed on several quality-improving focus points to work on after the meeting. Focus points were followed-up after three and 12 months. The impact on internship quality was assessed with departments' student evaluation scores, number of completed focus points, and the effect of completed focus points on a range of learning parameters. The CTF learned several things along the way, that potentially could affect the quality of internships. A shortlist of these was provided to illustrate unmeasurable benefits. Results: The CTF met with 53 out of 60 eligible departments. The CTF and departments agreed upon 197 focus points of which 64% were completed. The three most frequent categories of focus points were Introduction of the students, The departments' evaluation percentage, and The departments' function as an educational site. The mean student evaluation scores did not change significantly, but the individual evaluation parameters changed significantly in two categories. It decreased in the category regarding the students' satisfaction with the clinical lecturers and the scheduled teaching and increased in the category regarding the percentage of students evaluating the department. Conclusion: The CTF's triple-targeted approach did not increase the mean student evaluation score significantly. For departments that completed the agreed focus points, one category increased and another decreased. However, the unmeasurable benefits illustrated that CTF was a good viable linking element between the faculty, departments, and students with the potential of improving other aspects of the quality of internships.

Searching the core of emergency medicine.

BACKGROUND: The purpose of this study was to test whether focus groups involving medical students, house officers, senior doctors, and nurses could identify an undergraduate emergency medicine core curriculum. METHOD: From May 2001 to January 2002, we interviewed 12 homogeneous focus groups within all 88 participants. Three focus groups were composed of medical students; three of house officers, three of senior doctors, and three focus groups were composed of nurses. Each interview lasted 2 h. Interviews were recorded, transcribed, and analysed using qualitative methods. RESULTS: The focus groups suggested and discussed in all 196 objectives. Students, physicians, and nurses agreed that newly graduated physicians should master history taking, 21 clinical disorders, 15 practical skills, interpretation of two diagnostic tests, two general diagnostic skills, and two leadership skills. Apart from these 43 core objectives, disagreement was substantial. Participants gave very different priorities to communication, knowledge about clinical disorders, practical clinical skills, leadership, and "the art of medicine". CONCLUSION: In conclusion, focus groups could identify an emergency medicine core curriculum. However, participants had very different perspectives on the curriculum. Focus groups could be one very practicable part of seeking consensus on what is core and securing local roots and ownership to an undergraduate emergency medicine curriculum before and during implementation.

[Practical clinical skills in medical education 1--undergraduate education. A Delphi survey]. / Praktiske kliniske faerdigheder i den laegelige grunduddannelse 1--kandidatuddannelsen. En Delphi-undersøgelse.

INTRODUCTION: The necessity of defining standards in medical education is increasingly recognised. The aim of the present study was to adapt the Delphi method in establishing a consensus about competence levels of basic clinical skills in the undergraduate medical curriculum. METHOD: We used a Delphi design with two postal rounds. An expert panel of 52 physicians was selected on the criteria of knowledge and practical engagement in medical education. Questionnaires were set up with lists of 213 practical skills based on literature studies. Six levels of competence were identified. The task of the panel was to select the competence level for each skill. RESULTS: The panel reached a 75% level of consensus in 212 of the 213 skills. A core curriculum of basic clinical skills in the medical education of Danish undergraduates is proposed. DISCUSSION: The Delphi method was found applicable to qualify the process of identifying goals in a medical curriculum design.

[Practical clinical skills in medical education 2--internship. A Delphi survey]. / Praktiske kliniske faerdigheder i den laegelige grunduddannelse 2--turnusuddannelsen. En Delphi-undersøgelse.

INTRODUCTION: The aim of the present study was to use the Delphi technique to identify standards of quality for the curriculum of basic clinical skills in the pre-registration internship. METHOD: The Delphi method was used with a selected panel of 52 experts to set a level of competence for 213 practical clinical skills in a series of three questionnaires. RESULTS: For the pre-registration internship, the panel reached a 75% level of consensus for 80% of the basic clinical skills. A total of 47 basic clinical skills were identified (97% level of consensus) as core skills that should be mastered by the time of registration. DISCUSSION: The study suggests that further investigations should be performed to identify a core curriculum of basic clinical skills common to all pre-registration internists. In addition, a curriculum of electives should be based on the special characteristics of each training department.