The Intern Preparedness project aims to facilitate the effective preparedness of medical students for their internship, by increasing the flexibility of the modes of study and increasing active learning.



Kate Jurd
Principal Medical Education Officer
Medical Education Unit Toowoomba Hospital
eLearning Specialist
UQ Rural Clinical School
Toowoomba

Content expert: Dr Sheila Cook
Deputy Director Clinical Training UQ Rural Clinical School

The Intern Preparedness project aims to facilitate the effective preparedness of medical students for their internship, by increasing the flexibility of the modes of study and increasing active learning.



Kate Jurd
Principal Medical Education Officer
Medical Education Unit Toowoomba Hospital
eLearning Specialist
UQ Rural Clinical School
Toowoomba

Content expert: Dr Sheila Cook
Deputy Director Clinical Training UQ Rural Clinical School

The UQ Rural Clinical School delivers phase 2 of the MBBS/MD program across its four campuses (Toowoomba, Bundaberg, Hervey Bay and Rockhampton).


From student feedback there was a need to address the non-­medical challenges of internship

Project team consists of Dr Sheila Cook (content expert and program creator)
Remo Ostini (research)
Kate Jurd (eLearning and assessment design)
Marcella Qwan (Project Officer)
Maree Nicholls (Student Co-ordinator)

The UQ Rural Clinical School delivers phase 2 of the MBBS/MD program across its four campuses (Toowoomba, Bundaberg, Hervey Bay and Rockhampton).


From student feedback there was a need to address the non-­medical challenges of internship

Project team consists of Dr Sheila Cook (content expert and program creator)
Remo Ostini (research)
Kate Jurd (eLearning and assessment design)
Marcella Qwan (Project Officer)
Maree Nicholls (Student Co-ordinator)

In an open forum of 4th year medical students, prior to the OSCE examinations, we asked them what would assist them in their studies. Even with the examinations coming up they were more concerned about starting work and wanted specific teaching around the intern specific skills.

The program was technology enabled that required an innovative integration of face to face learning experiences with online experiences both of which focus on active learning and engagement.
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Using a flipped classroom model, which was both web and mobile enhanced – student access via learning management system or mobile device.

 

The implementation of active learning strategies throughout all components of the blended program ensures that students are continually practicing what they would do in a real world context, as well as critically analysing and reflecting on their learning and how this translates to the work environment. Online and f2f activities engage the students in authentic real world ward scenarios
The activities are designed as worked examples allowing students to observe, think and act in the way they are expected to perform in reality.

Assessment and research study

Pre and post program assessment tool
4 Evaluation surveys

Program evaluation included a test of ward management (9 items) and clinical ward skills (41 items) that students completed before the start of the program and again at the end of the program.

This involved three online eLearning modules that interactively presented examples of real scenarios from ward rounds, Following the daily activities of an organized and disorganized intern
These were to be completed prior to the corresponding workshops

After the mock scenarios, students were allocated to small groups facilitated by interns and residents. Discussion covering completing the forms, reflection of the process, an SBAR handover activity and tips and practical advice from the interns.

Jenny completed the digital evaluation surveys on her ipad. Each package was evaluated separately - any comments for improvement were used to modify the delivery of content and activities for the next workshop in the series.

One hundred percent of students rated the e-­‐modules as being ideal preparation for the tutorials
Outcomes from the 2015 evaluation of the program show that student feedback was overwhelmingly positive.

100% said that the small group learning was an ideal interactive style of learning.
And that the intern readiness package helped them feel better prepared for internship

Over 90% of students reported that the tutorial identified gaps in their knowledge and more than 70% of students reported an improvement in their skills in six of the ten domains addressed in the program.

The eLearning tutorials were very realistic, mimics real-life situations which reflected actual tasks that we will have to do next year.

The photos and captions were very entertaining and give it a real world feel

The workshops provided hands-on experience of a ward round scenario , where we had to do the jobs of an intern at the pace of a ward round. We were able to practice using the forms and this was followed by a discussion with Residents, which provided an opportunity to reflect on the learning.

Overall positive evaluation from students

Flipped learning model – eLearning complimented the workshops
eLearning modules effective – real world scenarios
Interactive hands-on workshop – practice being an intern
Resident led small group discussion – tips from interns
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• Refinement of program
Building on the aims of the 2015
• Ensure students are able to learn the ward-readiness skills
• Engage junior doctors in the small group sessions so that students can learn from their peers, ask questions that are too intimidated by their consultants to ask,
• Build the peer-to-peer relationships between students and the junior doctors
• Give junior doctors the chance to participate in medical education and contribute meaningfully to the development of the students as future colleagues
• If the experiences are positive, the program may increase the likelihood that students and residents elect to stay in the host hospital for further training
• Junior doctors may reflect on their role and learn new ideas to improve their own work practices

Given the success of this intern preparation program at UQ-­‐RCS Toowoomba, there is now an opportunity for this project to be extended to the broader student population of the RCS. The proposed Intern Preparedness program will use the same interactive eLearning activity and blended delivery model as in the previous program. For 2016 the program will be redesigned as a stand-¬‐alone program that can be delivered by local teaching staff at remote sites.

Revised intern skills pre and post assessment - with more rigor around questions and learning analytics to capture data for research - through Smart Sparrow

Pre intern skills assessment

400 4th year MBBS students

120 RCS students
280 non RCS students

21 assessment items

All students to complete follow up test 4 weeks after program

eLearning modules

An additional eLearning module was created for "How to cope with the bad days"

Package created to be delivered at all sites
It includes the powerpoint slides, Detailed explanations of the role and tasks of the facilitators, administrative support and RMO volunteers are included in the guidelines.
The facilitator will be the lead for the tutorial – introducing the tutorial and its aims, directing the students and the RMO volunteers to each component of the session and giving the concluding remarks
The administrative support is the key to the success of this program, so the guideline is detailed to support you along each step of the way
The RMO volunteers are central to the debriefing and learning in the small groups as the second, post-ward round component of the tutorial. They have key tasks and the guidelines provide prompt questions to help with this important conversation with students.
It includes the powerpoint slides, the video scenario, Administration guide, Facilitation guide and a detailed Resident teaching guide

Resident teachers who were happy to give up their time to support this program

1 uber workshop - similar format
accept the student activities are generated through the video patient scenarios.

Student activities are generated through the video patient scenarios.

Students listen to each patient scenario and then take notes, fill in the required forms as the patient conditions and management presents

Completing ward round tasks
prescribing, fluid order forms, pathology, xray

Small group discussion and SBAR activity where students are required to undertake a referral to a member of the the health team.

Debrief and reflection activity with the residents

Feedback

Feedback from junior doctors

Preparing for internship: focus on non technical skills.
Technology enabled, active learning, realistic patient scenarios, residents as teachers.
Scaffolding
- Building relationships:
(Student/Residents)
- Building partnerships (University/Hospital Health Service)

Using evaluation results to further refine program
and ascertain usefulness to rollout to broader Faculty of Medicine community.