Clinical exposure of interns during a general practice placement.

BACKGROUND: For more than a decade, junior doctors have undertaken general practice rotations; however, little is known about the breadth of medical conditions seen. This study aims to determine the breadth of clinical presentations encountered by interns during a rotation. METHODS: Data were collected on all patients seen by interns at an RA-2 general practice during 2012-13. Each condition identified was compared with the Australian Curriculum Framework for Junior Doctors (ACFJD) and coded according to the International Classification of Diseases 10th revision (ICD-10). RESULTS: Interns saw an average of 482.2 (SD = 38) patients per rotation (10.7 patients per day), 150.3 (SD = 15.4) ICD-10 codes per rotation and 49.8 (SD = 4.9; 57.2%) of the listed clinical symptoms and conditions in the ACFJD.

General practice placements for pre-registration junior doctors: adding value to intern education and training.

OBJECTIVE: To examine pre-registration junior doctors' perceptions of the value of a general practice term in their training program. DESIGN, SETTING AND PARTICIPANTS: Semi-structured interviews, in five teaching hospitals in South Australia in 2005, with 20 pre-registration junior doctors (interns) who had completed a general practice term and at least one core term of intern training. MAIN OUTCOME MEASURE: Comparisons between general practice and teaching hospital core training terms with respect to the domains of junior doctor education. RESULTS: Interns perceived general practice and teaching hospital terms to be complementary in their overall training program. The general practice term provided them with knowledge and skills they would not have acquired in the teaching hospital terms alone. One-on-one consulting, initiating patient management, and the opportunity to practise a range of practical and procedural skills were seen to be of particular value. CONCLUSIONS: The general practice and teaching hospital terms both contribute to the training of interns, offering contrasting environments and experiences which enhance interns' professional and personal growth. General practice terms should be considered for inclusion in intern training programs across Australia.

Comparison of three simulation-based training methods for management of medical emergencies.

Trainee medical officers (TMOs) participated in a study comparing three methods of simulation-based training to treat medical emergencies occurring in a hospital setting. The methods were: All groups had the same total teaching time. Participants (n=61) had an initial (pre-training) assessment by written tests, self assessment and simulations of medical emergencies ('VT' and 'HYPOglycaemia'). Participants were tested again post-training using similar simulations to the initial scenario and a new scenario ('ANAphylaxis'). Trained 'experts', blinded to the teaching group of participants, watched video-CDs of the simulations to assess participants' performance. All groups demonstrated increased knowledge and confidence (pre-training scores compared to post-training) but no differences could be detected between the three groups. In simulated emergencies, post-training scores were also improved. There was no difference between groups in the 'HYPO' scenario but in the 'VT' scenario there was moderate evidence that Group 3 was superior. In the 'ANA' scenario, Group 3 had far better test scores, especially in behavioural items. There did not appear to be any significant advantage of using whole body manikins over CSBT and simple part-task trainers. Full-mission simulation training helped develop the ability to recognise when skills learnt to manage one type of medical emergency can be useful in managing another emergency not previously encountered.