Bootcamp Rescue: A Needs-Driven Curriculum for Incoming Interns

Esther Schmidt-Pines,Paul Moglia

doi:10.29024/jsim.134

Abstract

Background: The transition between medical school and residency is challenging in many ways, including medical knowledge and procedural skills acquisition. Interns arrive with uneven baselines of clinical skill and knowledge, often feeling unprepared as they assume responsibility for patient care [3]. In addition to subjective feelings of anxiety, there is objective concern for being at increased risk for medical errors and providing suboptimal care [1, 2]. To ease the transition, an intern boot camp was created at Mount Sinai South Nassau’s Internal Medicine Residency to improve the pace at which this acquisition occurs and simultaneously reduce intern anxiety. Methods: The curriculum for boot camp was derived from a needs-based assessment provided by 70% of the first-year class. Participants listed various scenarios they had previously encountered on call, providing a taxonomy of the most encountered, on-call, clinical situations. A bootcamp booklet included a separate guide for each scenario, relevant phone numbers, guide to consultants, and a standardize procedure for sign-outs. Two senior attendings’ suggestions along with residents’ suggestions guided editing the booklet. One of the first-year residents conducted boot camp for two hours during June orientation for all 10 incoming interns. The booklet was provided to each intern with each scenario and sign-outs interactively discussed. Six months into residency, all interns (100%) evaluated the effectiveness of the bootcamp curriculum using a 5-point Likert scale on nine individual items. Results: One hundred percent (10/10) of the interns completed the survey. All strongly agreed or agreed (100%) bootcamp enhanced confidence, increased medical knowledge, and reduced the risk of potential error. Ninety percent (90%) believed bootcamp increased their efficiency. Prior to bootcamp, sixty percent (60%) reported a high anxiety level, 20% reported a very high anxiety level, and 20% reported their anxiety as neither high or low. After bootcamp, only 20% reported their anxiety was high, 40% reported their anxiety was neither low nor high, while 40% reported it was low. Ninety percent (90%) of interns reported the consultant guide was helpful, and half, 50%, reported the sign-out guide was helpful. Lastly, 90% felt there should be an intern boot camp for the next year of interns. Conclusions: An intern bootcamp can improve incoming interns’ confidence and knowledge, while lowering their anxiety, and possibly reduce medical errors.

Highlights

The transition between medical school and residency is challenging in many ways, including medical knowledge and procedural skills acquisition
Interns arrive with uneven baselines of clinical skill and knowledge, often feeling unprepared as they assume responsibility for patient care [3]
The curriculum for boot camp was derived from a needs-based assessment provided by 70% of the first-year class

Summary

Introduction

Background: The transition between medical school and residency is challenging in many ways, including medical knowledge and procedural skills acquisition. Interns arrive with uneven baselines of clinical skill and knowledge, often feeling unprepared as they assume responsibility for patient care [3]. In addition to subjective feelings of anxiety, there is objective concern for being at increased risk for medical errors and providing suboptimal care [1, 2]. An intern boot camp was created at Mount Sinai South Nassau’s Internal Medicine Residency to improve the pace at which this acquisition occurs and simultaneously reduce intern anxiety.

Results

Conclusion