Improved clinical training of internal medicine students in hospital wards

Background: Clinical training (CT) in internal medicine wards is a compulsory part of the internal medicine courses in Sweden. Aim: To ask physicians responsible for different CT programs about the perceived quality of their programs and about ideas of improvement. Hypothesis: The average quality of local CT programs is generally perceived as low by responsible physicians. Methods: The author combined a literature review with own experiences to develop a novel quality assurance questionnaire aimed at improving the overall quality of CT. Eight geographically spread teaching hospitals were included in the study. Telephone interviews were conducted with responsible physicians. The interviews contained two parts: The questionnaire developed by the author containing twenty-seven 5-point rating scale questions on the quality of the local CT and open-ended questions about suggestions for improvement of the local teaching organization. Medians and percentage of maximum total score of the rating scale questions were calculated and improvements suggested by the participants were summarized. Results: The average quality of the CT programs as measured by the total score of the developed questionnaire was 51% (of maximum 100%) and varied between hospitals (range 33%-65%). Conclusions: There seem to be a large potential for improvements in different CT programs. Improved collaboration between universities and teaching hospitals and the agreement on national standards could potentially improve the quality of CT in order to guarantee a uniform clinical education of high quality.