Current Internship Research Articles

Evolving Nurses into Home Health Care Practice

Home health care (HHC) is a regulated program of care delivered by a multidisciplinary team in the patient’s home. It is of high demand in Saudi Arabia; however there are shortages in health care personnel. Moreover, current internship programs do not address the concepts and unique skills involved in HHC practice. The purpose of this article is to present a HHC training program for registered nurses in Saudi Arabia, which aims at qualifying 60 nurses with high standards of knowledge, technical and communication skills, empowering them to overcome all the challenges faced during home visits. The training program consists of three sections provided over 2 months followed by an advanced course. It was designed based on the analysis, design, development, implementation, and evaluation model. This program will be the cornerstone of HHC subspecialty in the nursing colleges of Saudi Arabia, as a skill-based training program with outcomes that can be measured and evaluated. It will enable the HHC centers in Saudi Arabia to adequately address the shortages of qualified nurses.

Evaluation of clinical skills for first-year surgical residents using orientation programme and objective structured clinical evaluation as a tool of assessment

Postgraduate specialities require a combination of knowledge and clinical skills. The internship year is less structured. Clinical and practical skills that are picked up during training are not well regulated and the impact is not assessed. In this study, we assessed knowledge and skills using objective structured clinical examination (OSCE). To evaluate the clinical skills of new first-year surgical residents using orientation programme and OSCE as a tool for assessment. Observational study. Twenty new first-year surgical residents (10 each in 2008 and 2009) participated in a detailed structured orientation programme conducted over a period of 7 days. Clinically important topics and skills expected at this level (e.g., suturing, wound care etc.) were covered. The programme was preceded by an OSCE to test pre-programme knowledge (the "pre-test"). The questions were validated by senior department staff. A post-programme OSCE (the "post-test") helped to evaluate the change in clinical skill level brought about by the orientation programme. Wilcoxson matched-pairs signed-ranks test. Passing performance was achieved by all participants in both pre- and post-tests. Following the orientation programme, significant improvement was seen in tasks testing the psychomotor and cognitive domains. (P = 0.0001 and P = 0.0401, respectively). Overall reliability of the OSCE was found to be 0.7026 (Cronbach's coefficient alpha). This study highlighted the lacunae in current internship training, especially for skill-based tasks. There is a need for universal inclusion of structured orientation programmes in the training of first-year residents. OSCE is a reliable, valid and effective method for the assessment of clinical skills.

From Novice to Advanced Beginner

Our unit is a 12-bed medical-surgical intensive care unit in a small central Florida community. Finding experienced critical care nurses to fill vacancies is very difficult. We have offered a critical care internship for the past few years to attempt to augment our staff. Without the resources of a unit-based educator or clinical nurse specialist and with a very limited budget, we are committed to improving our internship to provide us with safe, competent critical care nurses who are willing to become members of our team. A literature review was conducted, and recommendations were developed to improve our current internship to better meet the needs of the unit and the beginning critical care nurses.

The Perception and Opinions for the 'Compulsory Clinical Training Program' of Postgraduate Medical Trainee

Background: Nowadays 2-year 'Compulsory Clinical Training Program' is on issue. The perception and opinions for the new training system of residents and interns may be essential to establish ideal postgraduate medical education. Methods: A questionnaire survey of postgraduate trainee from March to April 2008 was performed by person to person method. Gender, age, specialty, the location and the facility of the hospital, and 7 questions reflecting individual perception and opinions for the 'Compulsory Clinical Training Program' were reviewed. Results: Among in 1,314, 1,284 subjects completed the survey fully. We divided 1,284 sujects into 4 groups; Intern; Resident of Family Medicine; Resident of Internal Medicine or Pediatrics; Resident of other than Family Medicine, Internal Medicine and Pediatrics. About the vision for independent clinical skills through the 'Compulsory Clinical Training Program', most were negative. They were afraid of 'prolongation of current Internship' or 'unclear quality of the training course'. In case of setting the 'Compulsory Clinical Training Program', most chose additional resident courses for specialty. The main opinion about the ideal model of a primary physician was medical doctors who obtained primary care specialty. Conclusion: Most of the residents and interns think that the specialists of family medicine, internal medicine or pediatrics are suitable for primary care. And on wishing the additional residency course even after 'Compulsory Clinical Training Program', they doubt about the effi cacy of the new training system.

Providing a framework for graduate nurses

I read the article “Meeting the Needs of Graduate Nurses in Critical Orientation: Staged Orientation Program in Surgical Intensive Care” by Chestnutt and Everhart (June 2007:36–51) with great interest. Providing an effective framework to support graduate nurses as they make the transition from student to competent critical care nurse is a challenge we are all facing. The authors present a very practical approach to this orientation dilemma.The timing for publishing the article could not have been better. We were in the process of evaluating our current internship when Critical Care Nurse arrived. We will be incorporating some of the ideas presented in the article by Chestnutt and Ever-hart into our program for the fall.I would also like to complement the corresponding author Barb Male Chestnutt. She has been extremely generous and helpful, providing clarification as well as advice. There is so much value to being able to speak directly with the individual who has firsthand experience with the concepts being presented.Thank you for providing such a great resource!