Effects of experimental inductions for newly qualified doctors on competence at clinical procedures

摘要

Up to 96% of newly qualified doctors fail one or more clinical procedure tests. Their entrance into work in hospitals has been associated with significant reductions in patient safety and an increase in patient mortality. Curriculum changes offer one solution. Another solution is the introduction of clinical skills inductions (orientations) before doctors' first day at work; the failure rate for one or more clinical tests can be reduced from 96% of new doctors to 27% after just a 5-day experimental induction. Experiments reported in the literature showed improvements in new doctors' competence at intravenous line insertion and taking blood after a 5-day or 2-week induction, intravenous drug administration after a 5-day induction, certifying death, prescribing and out-of-hours tasks after a 2-week induction, and lumbar puncture and spirometry after a 1-day induction. Examined performance after a 5-day induction also showed improved objective structured clinical examination (OSCE) scores on blood pressure, cannulation, venepuncture and catheterisation. There is therefore value in scheduling inductions before doctors report for their first day on the job.