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Maintaining intern learning in the ED despite a 50% increase in intern numbers: Can a structured learning program be par

Maintaining intern learning in the ED despite a 50% increase in intern numbers: Can a structured learning program be part of the answer?. Presenter: Dr Catriona (Tri) Slater, MoLIE registrar, Emergency Department Other investigators: Dr Michelle Lees, Staff Specialist, Emergency Department

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Maintaining intern learning in the ED despite a 50% increase in intern numbers: Can a structured learning program be par

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  1. Maintaining intern learning in the ED despite a 50% increase in intern numbers: Can a structured learning program be part of the answer? Presenter: Dr Catriona (Tri) Slater, MoLIE registrar, Emergency Department Other investigators: Dr Michelle Lees, Staff Specialist, Emergency Department Ms Jenine Lawlor, Research Officer, PostGraduate Medical Education Unit The Townsville Hospital, Townsville, North Queensland

  2. MoreLearningforInterns in Emergency

  3. Townsville

  4. What do we already know? Intern numbers are increasing Australian EDs express concern about capacity to accommodate increasing numbers Published findings from Brisbane report enhanced intern learning experience on MoLIE program

  5. Research question How does the introduction of the MoLIE program affect interns’ self-reported confidence in their professional and clinical skills?

  6. Methodology Self-report questionnaires Administered pre and post ED term 1 year (5 terms) of data pre-MoLIE 4 terms of data post-MoLIE Ongoing data collection into 2011

  7. Professional Domain16 statements “I know what discharge instructions to give a patient after a wound repair”“I can provide basic airway support to an unconscious patient” Likert Scale (1) Strongly disagree (5) Strongly agree

  8. Skills Domain9 skills “Defibrillation”“Suturing a minor cut to the forehead” • Not confident to undertake skill independently • Confident to undertake skill with close supervision • Confident to undertake skill with minimal supervision • Confident to undertake the skill

  9. Properties of the questionnaire Reliability • Good Test-Retest Reliability (0.86 Professional domain, 0.84 skills domains) Validity • Series of interviews with interns

  10. Results: procedural skills2009 & 2010

  11. Results: clinical and professional domain 2009 & 2010

  12. Results: procedural skills

  13. Results: Professional skills

  14. Summary of findings No significant difference between confidence increase 2009-2010 (p > 0.05) Trend towards greater confidence increase in Professional Skills 2009 Trend towards greater confidence increase in Procedural Skills 2010

  15. Conclusions The MoLIE model achieved 2 aims: • It accommodated the 50% increase in intern numbers • It did not compromise intern confidence in their professional and procedural skills

  16. Limitations Questionnaire design • Inherited project • No consultation of epidemiologist in questionnaire design • No negatively geared items • Validity not studied during development • Missed opportunity for prospective 360° assessment Are we measuring the right thing?

  17. What next? Continued data collection and analysis in 2011 - Is what we have seen maintained? 360° assessment of impact of MoLIE program

  18. What are your questions?

  19. Acknowledgements At The Townsville Hospital: Mrs Allyson Agnew, Lead MEO Dr Carl O’Kane, DCT Ms Bronia Renison, Librarian From James Cook University: Dr David Kault And also: Dr Victoria Brazil Members of the MoLIE Statewide Committee, QLD

  20. MoLIE team 1 FTE Staff Specialist 1 FTE Medical Education Registrar 0.5 FTE Medical Education Officer 1 FTE Admin Officer

  21. MoLIE numbers state-wide RBWH (2008-2011) 380 PAH (2010-2011) 145 TTH (2010-2011) 114 GCH (2011) 84 Total 723

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