The Master's Apprentice: How do Australian medical interns learn?

Authors

  • Allyson Agnew Townsville Hospital & Health Service
  • Tarun Sen Gupta James Cook University
  • Frances Quirk Barwon Health
  • Rebecca Evans James Cook University
  • Sarah Larkins James Cook University

DOI:

https://doi.org/10.11157/fohpe.v18i1.207

Keywords:

medical education, internship, learning

Abstract

 Introduction: The 2015 Review of Medical Intern Training Discussion Paper (Australian Health Ministers' Advisory Council, 2015) questions the purpose and effectiveness of the current model of internship. However, there is limited literature describing how the medical internship functioned when first established in Australia, or how the educational model has changed over the years.

Methods: A study with the aim of determining how interns currently learn and the degree to which learning still follows an apprenticeship model was conducted over a 2-year period in a large Australian regional hospital. Sixty interns entered learning reflections into a 4-step online survey. A descriptive analysis was undertaken on the extracted data using Microsoft Excel. 

Results: Results of the study indicate that interns still learn via the apprenticeship relationship they have with their supervisors (registrars and/or consultants) more than they do via self-directed means. Findings from this study suggest that learning in medicine is an iterative process; interns will learn via modelling from their supervisors, on the one hand, but will use self-directed learning when and where necessary. Interns indicated learning more content than they do tasks related to administration or professional identity. There are varying emphases of learning in each of the core terms of medicine, surgery and emergency medicine, which suggests that it is important for interns to continue to have learning opportunities in a variety of settings and disciplines.

Conclusions: This study provides some insights into how and what interns learn, which should be considered when decisions are made about future models of medical intern training.

References

Australian Government Department of Health. (2014). Prevocational general practice placements program. Retrieved from http://www.health.gov.au/pgppp

Australian Health Ministers’ Advisory Council. (2015). Review of Medical Intern Training (Discussion paper). Retrieved from http://www.coaghealthcouncil.gov.au/MedicalInternReview/ArtMID/463/ArticleID/49/Discussion-Paper

Australian Medical Council. (2013). Intern training: National standards for programs. Canberra, ACT, Australia: Joint publication of the Medical Board of Australia. Retrieved from http://www.amc.org.au/files/37fdfb7b6fd3a1acdcc7800c23b42217737c2aa5_original.pdf

Confederation of Postgraduate Medical Education Councils. (2008). Australian curriculum framework for junior doctors. Retrieved from http://curriculum.cpmec.org.au/

Dent, A. W., Crotty, B., Cuddihy, H. L., Duns, G. C., Benjamin, J., Jordon, C. A.,

. . . Jolly, B. C. (2006). Learning opportunities for Australian prevocational hospital doctors: Exposure, perceived quality and desired methods of learning. Medical Journal of Australia, 184(9), 436–440.

Derrick, S., Badger, B., Chandler, J., Nokes, T., & Winch, G. (2006). The training/service continuum: Exploring the training/service balance of senior house officer activities. Medical Education, 40(4), 355–362.

Eley, D. S., Young, L., Wilkinson, D., Chater, A. B., & Baker, P. G. (2008). Coping with increasing numbers of medical students in rural clinical schools: Options and opportunities. Medical Journal of Australia, 188(11), 669–671.

Eraut, M. (2004). Informal learning in the workplace. Studies in Continuing Education, 26(2), 247–273.

Fink, A., Kosecoff, J., Chassin, M., & Brook, R. H. (1984). Concensus methods: Characteristics and guidelines for use. American Journal of Public Health, 74(9), 979–983.

Geffen, L. (2014). A brief history of medical education and training in Australia. Medical Journal of Australia, 201(1), S19–S22.

Higgs, J., & Andresen, L. (2001). The knower, the knowing and the known: Threads in the woven tapestry of knowledge. In J. Higgs & A. Titchen (Eds.), Practice knowledge and expertise in the health professions (pp. 10–21). Oxford, England: Butterworth-Heineman.

Joyce, C., Stoelwinder, J. U., McNeil, J. J., & Piterman, L. (2007). Riding the wave: Current and emerging trends in graduates from Australian university medical schools. Medical Journal of Australia, 186(6), 309–312.

Medical Board of Australia. (2016). Interns. Retrieved Jan, 2016, from http://www.medicalboard.gov.au/Registration/Interns.aspx

Medical Council of New Zealand. (2011). Policy for New Zealand and Australian graduates. Retrieved from https://www.mcnz.org.nz/get-registered/registration-policy/general-scope-policy/policy-for-new-zealand-and-australian-graduates/

Sen Gupta, T. K., Murray, R. B., McDonell, A., Murphy, B., & Underhill, A. D. (2008). Rural internships for final year students: Clinical experience, education and workforce. Rural Remote Health, 8(1), 827.

The UK Foundation Programme Office. (2015). Rough guide to the foundation programme (4th ed.). Retrieved Aug, 2015, from http://www.foundationprogramme.nhs.uk/pages/home

Westbrook, J. I., Ampt, A., Kearney, L., & Rob, M. I. (2008). All in a day's work: An observational study to quantify how and with whom doctors on hospital wards spend their time. Medical Journal of Australia, 188(9), 506–509.

Wilkinson, T., & Sheehan, D. (2011). Becoming a practitioner. Paper presented at the 16th National Prevocational Medical Education Forum, Auckland, New Zealand. Retrieved from http://www.prevocforum.org.nz/post-conference-presentation-files

Zhu, J. N., Weiland, T. J., Taylor, D. M., & Dent, A. W. (2008). An observational study of emergency department intern activities. Medical Journal of Australia, 188(9), 514–519.

Downloads

Published

2017-04-28

How to Cite

Agnew, A., Sen Gupta, T., Quirk, F., Evans, R., & Larkins, S. (2017). The Master’s Apprentice: How do Australian medical interns learn?. Focus on Health Professional Education: A Multi-Professional Journal, 18(1), 56–66. https://doi.org/10.11157/fohpe.v18i1.207

Issue

Section

Articles