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PRACTICAL ADVICE PAPER
Year : 2022 | Volume
: 35
| Issue : 3 | Page : 96-97
Need for and development of an intern health professions handbook in Uganda
Elsie Kiguli-Malwadde1, Annet Nambi1, Sarah Kiguli2, Henry Mwebesa3, Francis Omaswa1
1 African Centre for Global Health and Social Transformation, Uganda
2 Department of Pediatrics and Child Health, Uganda
3 Ministry of Health, Kampala, Uganda, Uganda
Correspondence Address:
Dr. Elsie Kiguli-Malwadde
African Centre for Global Health and Social Transformation, Kampala
Uganda
Source of Support: None, Conflict of Interest: None
CheckDOI: 10.4103/efh.efh_348_22
Health professions internship is the transition phase between being students to independent practitioners within the health system in many countries. Interns acquire the required practical skills in clinical, communication, and administrative matters that enable them to register as members of the health profession.[1],[2] In Uganda and other countries, internship is the first time these individuals have the responsibility of taking care of patients under minimal supervision. It is widely recognized as a very busy and challenging experience.[3],[4] Stress of internship can lead to burnout, mental health problems, and poor patient care.[3],[4],[5] In light of this, educators, regulators, and employers have come up with courses to address this challenge and help trainees build self-confidence and professional identity, maintain life balance, connections, and emotional responses, manage expectations, and facilitate teamwork.[6],[7],[8] These types of courses have not been offered in Uganda, possibly due to limited resources. In this article, we describe an internship induction program that incorporates an Intern Health Professions Handbook, entitled ”Handbook for Induction of Health Professions Interns in Uganda.”
Three organizations collaborated to develop the induction program: the African Center for Global Health and Social Transformation (ACHEST), the Ministry of Health (MOH) in Uganda, and the Health Professional Education Partnership Initiative (HEPI). The HEPI is a consortium of tertiary institutions consisting of Makerere University, Busitema University, Kabale University, Clarke International University, Mulago School of Nursing and Midwifery, Yale University, and Johns Hopkins University. The goals of our induction training are to assimilate new interns into the health system, help them understand the system, and learn procedures followed by the health sector. Training is also intended to help interns settle quickly into their new work environment and provide them with a sense of belonging.
An induction program was initially developed as an in-person course 4 years ago but shifted to online due to the COVID-19 pandemic. As a result of the pandemic, a 3-h induction course was offered online, 1½ h per day over 2 days. The course continues as an online course today in an effort to reach larger numbers of interns and maximize the impact of limited resources. Health and nonhealth professional experts are invited to give lectures and engage in discussion with interns just before they start their internship. The professionals include clinicians from medicine, pharmacy, nursing, and others, administrators from the MOH and Public Services, as well as colleagues who have recently gone through internship.
When funding from the HEPI Program ended, materials that had been created were organized into a handbook, following a daylong workshop convened and attended by the ACHEST faculty members as well as participants from the collaborating institutions of the MOH and Makerere University. At the workshop, attendees reviewed the material and reached a consensus on what to include in the handbook. The result was a handbook that contains a forward from the Ministry of Health and content on: acronyms, expectations and benefits of internship, career growth and professional development in health, role of professional associations and professional councils, managing stress, global health perspectives, joining the public service in Uganda, principles of quality assurance, nursing practice, and information on the Ugandan national health service [Figure 1]. The handbook is available in online and print versions. This is important as some internship centers in Uganda are remote, with limited or no Internet capabilities.
Systematic evaluation of the effectiveness of the Handbook for Induction of Health Professions Interns in Uganda has not been carried out, although anecdotal reports have been positive. We plan to conduct this evaluation using measures addressing such outcomes as handbook use (e.g., how often, for what reasons?), accessibility (including when and where used and comparison of responses between online and print users), and qualitative reviews by users, particularly related to recommendations regarding any shortcoming or additional information to be included.
In addition to supporting interns, we learned several valuable lessons. First, our collaboration effort was successful because we involved multiple stakeholders working together as a team, including prospective employers, health professions educators, facility managers, previous interns, and future interns. Second, stakeholders contributed information about key issues that affect newly qualified professionals, including the ability to manage expectations, maintaining work and life balance, career growth and professional development, stress management, and transitioning from being a trainee to a service provider. Third, we learned that having a structured intern induction program was critical, desirable, relevant, and appreciated. Having a handbook is an excellent way of ensuring that many interns can be reached and can effectively use the material.
A well-performing health workforce is one that is responsive, fair, and efficient and is capable of achieving the best possible health outcomes, given available resources and circumstances related to sufficient staffing, equitable distribution, competencies, responsiveness, and productivity. This can only happen if newly qualified health professionals are well guided and informed about what to expect and how they may maximize an internship period to both their benefit and the benefit of the population they serve. We have no doubt that this handbook will assist and support interns in Uganda, and potentially, it can be adapted and adopted to help interns in other countries with similar circumstances to Uganda.
Acknowledgment
The work reported in this publication was supported by the Fogarty International Center of the National Institutes of Health, U.S., Department of State's Office of the U.S., Global AIDS Coordinator and Health Diplomacy (S/GAC), and President's Emergency Plan for AIDS Relief under Award Number 1R25TW011213. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Financial support and sponsorship
The work reported in this publication was supported by the Fogarty International Center of the National Institutes of Health, U.S. Department of State's Office of the U.S. Global AIDS Coordinator and Health Diplomacy (S/GAC), and President's Emergency Plan for AIDS Relief (PEPFAR) under Award Number 1R25TW011213. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Conflicts of interest
There are no conflicts of interest.
References
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