UCSF

Background

Providing a robust continuity clinic experience is difficult due to uneven distribution of resident time. Immersion experiences early in training may improve residents' learning experiences.

Objective

We designed and implemented a continuity immersion experience to improve internal medicine interns' satisfaction and confidence with their outpatient skills, and we evaluated the timing of the experience and its benefits for learners.

Methods

Two cohorts of interns at 1 academic institution participated in a 3-week immersion block (during the first or second quarter of the intern year). Interns were surveyed twice about satisfaction and confidence. Analysis included independent and paired sample t tests to compare interns' responses pre- and postimmersion, and to evaluate effects over time.

Results

A total of 124 interns completed the immersion, with a survey response rate of 61%. Interns' self-rated confidence on a 5-point Likert scale improved significantly compared with preimmersion in the areas of medical knowledge and confidence with their electronic health record and communication skills (P ≤ .010 for all assessments). Interns reported high satisfaction with continuity clinic following immersion (cohort 1: 4.5 ± 0.54; cohort 2: 4.3 ± 0.68; on a 5-point scale with 5 = very satisfied). Improvements in knowledge, skills, and satisfaction in cohort 1 were sustained over 3 months.

Conclusions

A 3-week immersion experience in the first 6 months of residency improved interns' confidence in ambulatory content areas and satisfaction with clinic.