Document Type : Original Article

Authors

• . Mohammad Reza Akhlaghi
• . Vajiheh Vafamehr
• . Mohammad Dadgostarnia
• . Alireza Dehghani

Introduction to Clinical Medicine (ICM) Department, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Introduction: In this study, by using a problem‑oriented approach in the needs assessment,
identifying the defects and deficiencies in emergency health training centers has been
determined as the basis for the requirements. The main objective of the study was the
implementation of surgical emergencies integration of the five surgical groups (general surgery,
urology, orthopedics, neurosurgery, and ENT) to meet the needs and determining its efficacy.
Materials and Methods: This interventional study was conducted in three phases: (1) Phase I(design
and planning): Needs assessment, recognition of implementation barriers and providing the objectives
and training program for integrated emergencies. (2) Phase II (implementation): Justification of
the main stakeholders of the project, preparation of students’ duties in the emergency department,
preparation of on‑duty plans, supervising the implementation of the program, and reviewing the
plan in parallel with the implementation based on the problems. (3) Phase III (evaluation): Reviewing
the evidences based on the amount of efficiency of the plan and justification for its continuation. In
the first and the second phase, the data were collected through holding focus group meetings and
interviews. In the third phase, the opened‑reply and closed‑reply researcher‑made questionnaires were
used. The questionnaire face and content validity were confirmed by experts and the reliability
was assessed by calculating the Cronbach’s alpha. Results: According to the views of the
interns, assistants, teachers, and emergency personnel, the positive features of the plan included
the following: Increasing the patients’ satisfaction, reducing the patients’ stay in the Emergency
Department, increasing the speed of handling the patients, balancing the workloads of the interns,
direct training of interns by young teachers of emergency medicine, giving the direct responsibility
of the patient to the intern, practical and operational training of emergency issues, increasing the
teamwork, facing a variety of patients, practicing the role of general practitioners, role‑playing on a real
patient’s bedside, having a multilateral approach to the patient, reducing the wasting time on minor
wards, balancing the work and rest schedules of the interns, and better learning and satisfaction
of the interns. Over 60% of the participants believed the program has the following benefits: More
attention on the training plan, improving the learning of patient management, being more responsive
for the training of interns, increasing operational approach to emergency patients, being more
aware of the performed actions, and increasing  the quality and speed of services provided to patients. The mean score assigned to the whole questionnaire of investigating the viewpoints was 37.5 out of 50. The mean score of the interns’ questionnaire was significantly more than the mean score of the assistants. Discussion: The results obtained indicated that the greatest existing consensus about this plan was the positive impact on the learning of interns in the emergency setting. Thus, it will not only increase the number of patients who the interns are managing
during the internship course, but also increases the balance of their workload and they can learn and manage the emergency patients with more leisure.

Keywords

• Emergency medicine
• internship
• surgical emergency