Intern underperformance is detected more frequently in emergency medicine rotations

Objective: To determine the frequency and nature of intern underperformance as documented on in-training assessment forms. Methods: A retrospective review of intern assessment forms from a 2 year period (2009–2010) was conducted at a tertiary referral hospital in Brisbane, Queensland. The frequency of interns assessed as ‘requiring substantial assistance’ and/or ‘requires further development’ on mid- or end-of-term assessment forms was determined. Forms were analysed by the clinical rotation, time of year and domain(s) of clinical practice in which underperformance was documented. Results: During 2009 and 2010 the overall documented incidence of intern underperformance was 2.4% (95% CI 1.5–3.9%). Clinical rotation in emergency medicine detected significantly more underperformance compared with other rotations (P < 0.01). Interns predominantly had difficulty with ‘clinical judgment and decision-making skills’, ‘time management skills’ and ‘teamwork and colleagues’ (62.5%, 55% and 32.5% of underperforming assessments, respectively). Time of the year did not affect frequency of underperformance. A proportion of 13.4% (95% CI 9.2–19.0%) of interns working at the institution over the study period received at least one assessment in which underperformance was documented. Seventy-six per cent of those interns who had underperformance identified by mid-term assessment successfully completed the term following remediation. Conclusion: The prevalence of underperformance among interns is low, although higher than previously suggested. Emergency medicine detects relatively more interns in difficulty than other rotations.

The professional socialisation of paramedics : the transition from intern to qualified paramedic

The professional socialisation of paramedics encompasses preconceptions developed during childhood and early adulthood, and subsequent changes in perceptions resulting from university studies, clinical placements and encountering the professional workplace as an employee. This study investigates the professional socialisation of university educated paramedics making the transition from paramedic intern to qualified paramedic. Participants were sought from several of Australia’s larger ambulance services and UK NHS Ambulance Trusts to take part in this study. Participants were recruited through Ambulance Service Research Institutes, Clinical Governance Departments and university databases. To be included in this study, participants were required to be university educated, have completed a professional internship year and achieved qualified or registered paramedic status. Data collection was via face to face semi-structured interviews. Transcripts were analysed using socialisation models from the nursing and allied health disciplines and a grounded theory approach. The study found that participants initially enjoyed their new professional status after completing their internship and becoming qualified paramedics. However, for many the excitement of becoming a qualified paramedic was short lived. Newly qualified paramedics experienced increased levels of responsibility and were required to develop mentoring skills while still adjusting to their new roles. Participants had to contend with inner conflicting views about the reality of paramedic work which were developed though preconceptions and experiences as paramedic interns. The transition from paramedic intern to qualified paramedic is reportedly a challenging experience, as newly qualified paramedics are required to deal with added complexities while still adjusting to their new roles.

Teacher leadership : interns crossing to the domain of higher professional learning with mentors?

Over the last two decades, the notion of teacher leadership has emerged as a key concept in both the teaching and leadership literature. While researchers have not reached consensus regarding a definition, there has been some agreement that teacher leadership can operate at both a formal and informal level in schools and that it includes leadership of an instructional, organisational and professional development nature (York-Barr & Duke, 2004). Teacher leadership is a construct that tends not to be applied to pre-service teachers as interns, but is more often connected with the professional role of mentors who collaborate with them as they make the transition to being a beginning teacher. We argue that teacher leadership should be recognised as a professional and career goal during this formative learning phase and that interns should be expected to overtly demonstrate signs, albeit early ones, of leadership in instruction and other professional areas of development. The aim of this paper is to explore the extent to which teacher education interns at one university in Queensland reported on activities that may be deemed to be ‘teacher leadership.’ The research approach used in this study was an examination of 145 reflective reports written in 2008 by final Bachelor of Education (primary) pre-service teachers. These reports recorded the pre-service teachers’ perceptions of their professional learning with a school-based mentor in response to four outcomes of internship that were scaffolded by their mentor or initiated by them. These outcomes formed the bases of our research questions into the professional learning of the interns and included, ‘increased knowledge and capacity to teach within the total world of work as a teacher;’ ‘to work autonomously and interdependently’; to make ‘growth in critical reflectivity’, and the ‘ability to initiate professional development with the mentoring process’. Using the approaches of the constant comparative method of Strauss and Corbin (1998) key categories of experiences emerged. These categories were then identified as belonging to main meta-category labelled as ‘teacher leadership.’ Our research findings revealed that five dimensions of teacher leadership – effective practice in schools; school curriculum work; professional development of colleagues; parent and community involvement; and contributions to the profession – were evident in the written reports by interns. Not surprisingly, the mentor/intern relationship was the main vehicle for enabling the intern to learn about teaching and leadership. The paper concludes with some key implications for developers of preservice education programmes regarding the need for teacher leadership to be part of the discourse of these programmes.

Making the transition from pharmacy student to pharmacist: Australian interns' perceptions of professional identity formation

Objectives The experience of transitioning from university to practice influences professional identity formation. It is unclear how this transitioning experience influences pharmacy interns' professional identities. This study aims to examine pharmacy interns' perceptions of their transition from university to the workplace and the influence this had on their pharmacist identities. Methods A qualitative approach using in-depth interviews was adopted for this study. Fifteen interns (community and hospital) from one school of pharmacy in Australia were interviewed. Questions were asked about the nature of their current intern role, their university experiences, how they saw themselves as pharmacists and their perceptions of the transition to practice. Key findings The interns interviewed entered the workplace valuing patient-focused aspects of practice and contributing to patient care. The nature of work meant there were limited opportunities to enact these aspects of their professional identities. The interns were challenged by interactions with patients and doctors, and experienced difficulties reconciling this with their university-derived professional identities. Also, the interns lacked the confidence and strategies to overcome these challenges. Some were exploring alternative ways of being pharmacists. Conclusions This paper argues that graduates' experience of the transition to practice was challenging. This was due to nascent professional identities formed in university and a lack of workplace experiences enabling patient-centred practices. The interns' formation of professional identities was highly responsive to the context of work. To facilitate the development of Australian patient-centred pharmacy practice, supporting professional identity formation should be a focus within pharmacy education.