title: Intern underperformance is detected more frequently in emergency medicine rotations.
abstract: OBJECTIVE
  To determine the frequency and nature of intern underperformance as documented on in-training assessment forms.
  
  
  METHODS
  A retrospective review of intern assessment forms from a 2 year period (2009-2010) was conducted at a tertiary referral hospital in Brisbane, Queensland. The frequency of interns assessed as 'requiring substantial assistance' and/or 'requires further development' on mid- or end-of-term assessment forms was determined. Forms were analysed by the clinical rotation, time of year and domain(s) of clinical practice in which underperformance was documented.
  
  
  RESULTS
  During 2009 and 2010 the overall documented incidence of intern underperformance was 2.4% (95% CI 1.5-3.9%). Clinical rotation in emergency medicine detected significantly more underperformance compared with other rotations (P < 0.01). Interns predominantly had difficulty with 'clinical judgment and decision-making skills', 'time management skills' and 'teamwork and colleagues' (62.5%, 55% and 32.5% of underperforming assessments, respectively). Time of the year did not affect frequency of underperformance. A proportion of 13.4% (95% CI 9.2-19.0%) of interns working at the institution over the study period received at least one assessment in which underperformance was documented. Seventy-six per cent of those interns who had underperformance identified by mid-term assessment successfully completed the term following remediation.
  
  
  CONCLUSIONS
  The prevalence of underperformance among interns is low, although higher than previously suggested. Emergency medicine detects relatively more interns in difficulty than other rotations.
authors: Department of Emergency Medicine, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
authors: Narelle
authors: N
authors: Aram
authors: Victoria
authors: V
authors: Brazil
authors: Lorna
authors: L
authors: Davin
authors: Jaimi
authors: J
authors: Greenslade
mesh_terms: D000328:Adult; D002983:Clinical Competence / Q000592:standards*; D004503:Education, Medical, Graduate / Q000379:methods*; D004521:Educational Measurement / Q000379:methods; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D016015:Logistic Models; D011361:Professional Competence / Q000592:standards; D011793:Queensland; D012189:Retrospective Studies