Strengthening medical training programmes by focusing on professional transitions: a national bridging programme to prepare medical school graduates for their role as medical interns in Botswana

BMC Medical Education

Research Article

Michael J. Peluso¹  Neo Tapela²  Rebecca Luckett³  Tomer Barak⁴  Miriam Haverkamp⁵  Savara Mantzor⁶  Mosepele Mosepele⁷  Alemayhu G. Bedada⁸  Rosa Maoto⁹  Detlef Prozesky^1,10  Oathokwa Nkomazana^1,11  Cecil Haverkamp^1,12  Paul Saleeb^1,13 

[1] Botswana-Harvard Partnership, Gaborone, Botswana;Department of Medicine and Division of Global Health Equity, Brigham and Women’s Hospital, Boston, MA, USA;Harvard Medical School, Boston, USA;Botswana-Harvard Partnership, Gaborone, Botswana;Department of Medicine and Division of Global Health Equity, Brigham and Women’s Hospital, Boston, MA, USA;Harvard Medical School, Boston, USA;Department of Medicine, Princess Marina Hospital, Gaborone, Botswana;Botswana Ministry of Health, Gaborone, Botswana;Botswana-Harvard Partnership, Gaborone, Botswana;Harvard Medical School, Boston, USA;Department of Obstetrics and Gynecology, Scottish Livingstone Hospital, Molepolole, Botswana;Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, USA;Botswana-Harvard Partnership, Gaborone, Botswana;Harvard Medical School, Boston, USA;Medical Internship Training Programme, Gaborone, Botswana;Department of Medicine, Scottish Livingstone Hospital, Molepolole, Botswana;Department of Medicine, Beth Israel Deaconess Medical Center, Boston, USA;Botswana-UPenn Partnership, Gaborone, Botswana;Department of Medicine, Princess Marina Hospital, Gaborone, Botswana;Children’s Hospital of Philadelphia, Philadelphia, USA;Department of Paediatrics, Princess Marina Hospital, Gaborone, Botswana;Botswana-UPenn Partnership, Gaborone, Botswana;Department of Medicine, Princess Marina Hospital, Gaborone, Botswana;Department of Surgery, Faculty of Medicine, University of Botswana, Gaborone, Botswana;Medical Internship Training Programme, Gaborone, Botswana;Medical Internship Training Programme, Gaborone, Botswana;Department of Medical Education, University of Botswana, Gaborone, Botswana;Medical Internship Training Programme, Gaborone, Botswana;Faculty of Medicine, University of Botswana, Gaborone, Botswana;University Research Co., Gaborone, Botswana;University of Maryland, College Park, MD, USA;Botswana-University of Maryland School of Medicine Health Initiative, Gaborone, Botswana;

关键词: Graduate medical education;    Global health;    Sub-Saharan Africa;    Health workforce;    Capacity building;   

DOI  :  10.1186/s12909-017-1102-1

 received in 2017-04-11, accepted in 2017-12-12,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe improvement of existing medical training programmes in resource-constrained settings is seen as key to addressing the challenge of retaining medical graduates trained at considerable cost both in-country and abroad. In Botswana, the establishment of the national Medical Internship Training Programme (MIT) in 2014 was a first step in efforts to promote retention through the expansion and standardization of internship training, but MIT faces a major challenge related to variability between incoming trainees due to factors such as their completion of undergraduate medical training in different settings. To address this challenge, in August 2016 we piloted a bridging programme for foreign and locally trained medical graduates that aimed to facilitate their transition into internship training. This study aimed to describe the programme and evaluate its impact on the participants’ self-rated perceptions of their knowledge, experience, clinical skills, and familiarity with Botswana’s healthcare system.MethodsWe conducted a national, intensive, two-week programme designed to facilitate the transition from medical student to intern and to prepare all incoming interns for their work in Botswana’s health system. Participants included all interns entering in August 2016. Formats included lectures, workshops, simulations, discussions, and reflection-oriented activities. The Kellogg Foundation Outcomes Logic Model was used to evaluate the programme, and participants self-rated their knowledge, skills, and attitudes across each of the programme objectives on paired questionnaires before and after participation.Results48/54 participants (89%) provided paired data. Participants reported a high degree of satisfaction with the programme (mean 4.2/5). Self-rated preparedness improved after participation (mean 3.2 versus 3.7, p < 0.001), as did confidence across 18/19 knowledge/skill domains, suggesting that participants felt that the programme prepared them for their internship training. Exploratory analysis revealed that 20/25 participants (80%) reporting either no effect or a negative effect following participation had rated themselves “extremely” or “quite” prepared beforehand, suggesting the programme grounded expectations for interns who initially were overconfident. In contrast, no interns who had initially rated themselves “moderately” or “somewhat” prepared reported a decline in their self-rated sense of preparedness. Interns commented on the benefits of learning about roles/responsibilities, interacting with clinicians from Botswana’s healthcare sectors, and the sense of community the programme engendered.ConclusionsThis programme was feasible to implement and was well-received by participants. Overall, participants perceived an enhancement of their knowledge, skills, and expectations about their role in Botswana’s health system after completion of the programme. Our results are likely to be of interest to educators dedicated to training, professional transitions, and career pathways in similar settings in the region and beyond.

【 授权许可】

CC BY   
© The Author(s). 2017