Integrated surgical emergency training plan in the internship: A step toward improving the quality of training and emergency center management
نویسندگان
1 Introduction to Clinical Medicine (ICM) Department, Isfahan University of Medical Sciences, Isfahan, Iran
2 Introduction to Clinical Medicine (ICM) Department, Isfahan University of Medical Sciences, Isfahan, Iran
3
4 Introduction to Clinical Medicine (ICM) Department, Isfahan University of Medical Sciences, Isfahan, Iran
doi
چکیده
Introduction: In this study, by using a problem‑oriented approach in the needs assessment,identifying the defects and deficiencies in emergency health training centers has beendetermined as the basis for the requirements. The main objective of the study was theimplementation of surgical emergencies integration of the five surgical groups (general surgery,urology, orthopedics, neurosurgery, and ENT) to meet the needs and determining its efficacy.Materials and Methods: This interventional study was conducted in three phases: (1) Phase I(designand planning): Needs assessment, recognition of implementation barriers and providing the objectivesand training program for integrated emergencies. (2) Phase II (implementation): Justification ofthe main stakeholders of the project, preparation of students’ duties in the emergency department,preparation of on‑duty plans, supervising the implementation of the program, and reviewing theplan in parallel with the implementation based on the problems. (3) Phase III (evaluation): Reviewingthe evidences based on the amount of efficiency of the plan and justification for its continuation. Inthe first and the second phase, the data were collected through holding focus group meetings andinterviews. In the third phase, the opened‑reply and closed‑reply researcher‑made questionnaires wereused. The questionnaire face and content validity were confirmed by experts and the reliabilitywas assessed by calculating the Cronbach’s alpha. Results: According to the views of theinterns, assistants, teachers, and emergency personnel, the positive features of the plan includedthe following: Increasing the patients’ satisfaction, reducing the patients’ stay in the EmergencyDepartment, increasing the speed of handling the patients, balancing the workloads of the interns,direct training of interns by young teachers of emergency medicine, giving the direct responsibilityof the patient to the intern, practical and operational training of emergency issues, increasing theteamwork, facing a variety of patients, practicing the role of general practitioners, role‑playing on a realpatient’s bedside, having a multilateral approach to the patient, reducing the wasting time on minorwards, balancing the work and rest schedules of the interns, and better learning and satisfactionof the interns. Over 60% of the participants believed the program has the following benefits: Moreattention on the training plan, improving the learning of patient management, being more responsivefor the training of interns, increasing operational approach to emergency patients, being moreaware of the performed actions, and increasing the quality and speed of services provided to patients. The mean score assigned to the whole questionnaire of investigating the viewpoints was 37.5 out of 50. The mean score of the interns’ questionnaire was significantly more than the mean score of the assistants. Discussion: The results obtained indicated that the greatest existing consensus about this plan was the positive impact on the learning of interns in the emergency setting. Thus, it will not only increase the number of patients who the interns are managingduring the internship course, but also increases the balance of their workload and they can learn and manage the emergency patients with more leisure.