Assigning Online Educational Modules Before Orientation Increases Interns’ Level of Readiness for Internship

Transitioning to residency is a stressful time in the life of a new physician as they bear significantly increased patient care responsibilities. Program directors and hospital administrators responsible for patient safety also share concerns regarding resident preparedness. 1 For the past 5 years, NYU Grossman School of Medicine has been providing incoming interns with e-learning modules before commencing their residency as a means of addressing issues related to patient assessment, management, and patient safety. We postulated that during the period between Match day and July 1, soon-to-be-residents would have the time and be eager to focus on patient care issues. 2 We studied whether these trainees would view the modules and, if so, find them helpful in their preparation for residency. NYU Grossman School of Medicine faculty created a series of 12 online educational modules (WISE-OnCall) to address acute presentations of common clinical problems such as dyspnea, chest pain, abdominal pain, fever/sepsis, and oliguria. Each module was designed specifically for senior medical students and early interns with an emphasis on distinguishing life-threatening diagnoses from more benign causes. The importance of recognizing potentially critical situations from among the many possible diagnoses, initiating management, and escalating concerns to seniors is addressed in each of the modules. In 2017, we began assigning a subset of these modules to incoming interns in selected residency programs. Each subsequent year additional NYU residency programs participated and assigned modules to their incoming interns. In 2021, all incoming interns were assigned all 12 modules to complete. During orientation, incoming NYUGSOM interns participate in First Night on Call, a 4-hour simulation session that emphasizes patient safety and escalating problems to a superior during common clinical scenarios. 3 Trainees complete a survey at the end of this session. In 2017, 2018, and 2019, we also surveyed the trainees again 6 months into their intern year. Over 4 years (n = 753), 86.6% of interns reported that they either agreed or strongly agreed that the WISE-OnCall modules increased their readiness for internship. Additionally, 86.9% of interns reported that they either agreed or strongly agreed that the WISE-OnCall modules provided them with a framework to organize clinical information during First Night On Call (Patient Safety Orientation). In 2017–2019, we also surveyed the interns 6 months later. Of 214 respondents, 62.6% of interns reported that they would recommend WISE-OnCall modules to future incoming interns. Incoming interns are primed for learning about acute clinical issues they are likely to encounter early in their training. Providing interns with a series of online educational modules before their orientation is a highly feasible and acceptable approach to help prepare them. Since these online educational modules are focused on the recognition and management of acute inpatient problems, they help our trainees develop a framework for organizing clinical information and to feel more confident in their preparation for early internship. Follow-up surveys 6 months later reinforce the usefulness of the modules. These WISE OnCALL e-learning modules allow incoming interns an opportunity to familiarize themselves with clinical problems they will encounter before being integrated into a fast-paced and complex health care system. E-learning via online educational modules is an excellent format for supporting trainees’ readiness for internship. Interns are primed for learning shortly before starting residency and enthusiastically embrace resources developed to help their clinical skills

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