Narelle Aram, MBBS (Hons), FACEM, BSc (Biomedical), Advanced Trainee; Victoria Brazil, MBBS, FACEM, MBA, Senior Staff Specialist, Associate Professor; Lorna Davin, BAppSc, MA, GCertAdultEd, Medical Education Officer, PhD Candidate; Jaimi Greenslade, BPsych (Hons), PhD, Research Officer, Associate Professor, Senior Lecturer.
Education and Training
Intern underperformance is detected more frequently in emergency medicine rotations
Article first published online: 20 DEC 2012
© 2012 The Authors. EMA © 2012 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine
Emergency Medicine Australasia
Volume 25, Issue 1, pages 68–74, February 2013
How to Cite
Aram, N., Brazil, V., Davin, L. and Greenslade, J. (2013), Intern underperformance is detected more frequently in emergency medicine rotations. Emergency Medicine Australasia, 25: 68–74. doi: 10.1111/1742-6723.12031
- Issue published online: 4 FEB 2013
- Article first published online: 20 DEC 2012
- Manuscript Accepted: 14 NOV 2012
- emergency medicine;
- medical education
To determine the frequency and nature of intern underperformance as documented on in-training assessment forms.
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.
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.
The prevalence of underperformance among interns is low, although higher than previously suggested. Emergency medicine detects relatively more interns in difficulty than other rotations.