Please use this identifier to cite or link to this item: http://bura.brunel.ac.uk/handle/2438/30512
Title: Development and validation of a new measurement instrument to assess internship experience of medical doctors in low-income and middle-income countries
Authors: Zhao, Y
Jalloh, S
Lam, PK
Kwarshak, YK
Mbuthia, D
Misago, N
Namedre, M
Thi Bé Phương, N
Qaloewa, S
Summers, R
Tang, K
Tweheyo, R
Wills, B
Zhang, F
Nicodemo, C
Gathara, D
English, M
Issue Date: 8-Nov-2023
Publisher: BMJ Publishing Group
Citation: Zhao, Y. et al. (2023) 'Development and validation of a new measurement instrument to assess internship experience of medical doctors in low-income and middle-income countries', BMJ Global Health, 8 (11), e013399, pp. 1 - 12. doi: 10.1136/bmjgh-2023-013399.
Abstract: Routine surveys are used to understand the training quality and experiences of junior doctors but there are lack of tools designed to evaluate the training experiences of interns in low-income and middle-income countries (LMICs) where working conditions and resource constraints are challenging. We describe our process developing and validating a ‘medical internship experience scale’ to address this gap, work involving nine LMICs that varied in geographical locations, income-level and internship training models. We used a scoping review of existing tools, content validity discussions with target populations and an expert panel, back-and-forth translations into four language versions and cognitive interviews to develop and test the tool. Using data collected from 1646 interns and junior medical doctors, we assessed factor structure and assessed its reliability and validity. Fifty items about experiences of medical internship were retained from an initial pool of 102 items. These 50 items represent 6 major factors (constructs): (1) clinical learning and supervision, (2) patient safety, (3) job satisfaction, (4) stress and burnout, (5) mental well-being, and (6) fairness and discrimination. We reflect on the process of multicountry scale development and highlight some considerations for others who may use our scale, using preliminary analyses of the 1646 responses to illustrate that the tool may produce useful data to identify priorities for action. We suggest this tool could enable LMICs to assess key metrics regarding intern straining and initial work experiences and possibly allow comparison across countries and over time, to inform better internship planning and management.
Description: Summary: Internship experience can be challenging due to the rapid transition from medical school to clinical practice, especially long working hours, high workloads and constant new learning and assessment. Countries like the UK and US conduct routine surveys of their doctors in training, led by regulators, to understand their experiences and monitor and report on training quality. However, most low-income and middle-income countries (LMICs) do not have similar routine surveys and there is a relative lack of research on internship experiences in these countries. With collaborators from 9 LMICs, we developed a 50-item Medical Internship Experience Scale (MIES) based on data from 1646 medical interns and junior doctors from LMICs. MIES is reliable and valid and broadly covers six major constructs, that is, clinical learning and supervision, patient safety, job satisfaction, stress and burnout, mental wellbeing, fairness and discrimination, and this tool could be used by governments, medical schools and regulators to compare internship experiences across different training facilities and to identify specific areas where improvements are needed.
Data availability statement: Data are available upon reasonable request. The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.
Supplemental material is available online at: https://gh.bmj.com/content/8/11/e013399#supplementary-materials .
URI: https://bura.brunel.ac.uk/handle/2438/30512
DOI: https://doi.org/10.1136/bmjgh-2023-013399
Other Identifiers: ORCiD: Yingxi Zhao https://orcid.org/0000-0002-4937-4703
ORCiD: Yakubu Kevin Kwarshak https://orcid.org/0000-0002-0555-9220
ORCiD: Kun Tang https://orcid.org/0000-0002-5444-186X
ORCiD: Catia Nicodemo https://orcid.org/0000-0001-5490-9576
ORCiD: Mike English https://orcid.org/0000-0002-7427-0826
e013399
Appears in Collections:Brunel Business School Research Papers

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