Interns' performances with simulated patients at the beginning and the end of the intern year

Objective:To determine whether interns' performances of technical, preventive, and communication aspects of patient care improve during the intern year. Design:A descriptive study. At the beginning and end of the intern year, interns' consultations with three simulated (standardized) patients were videotaped and scored according to explicit criteria set by an expert panel. Problems simulated were urinary tract infection, bronchitis, and tension headache. Setting:The casualty outpatient department in a general teaching hospital in New South Wales, Australia. Participants:Twenty-eight interns rotated to the casualty department. Results:Little improvement over the intern year in technical competence or preventive care was observed, even though initial levels of compliance with criteria were quite low for some items. Greater improvement was apparent in the area of communication skills. Conclusions:The results suggest that the internship should be restructured to more adequately teach the skills required for primary care.