Tracking Clinical Competency Growth: A Longitudinal Study of Medical Students in a Multidisciplinary Emergency Department Internship Program

Tzu-Ching Sung,1 Hsin-I Shih,2– 4 Takeshi Kawaguchi,5 Chih-Hsien Chi,2,3 Hsiang-Chin Hsu3,6 1School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan; 2Department of Emergency Medicine, National Cheng Kung University Hospital, National Cheng Kung Unive...

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Main Authors: Sung TC, Shih HI, Kawaguchi T, Chi CH, Hsu HC
Format: Article
Language:English
Published: Dove Medical Press 2025-07-01
Series:Journal of Multidisciplinary Healthcare
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Online Access:https://www.dovepress.com/tracking-clinical-competency-growth-a-longitudinal-study-of-medical-st-peer-reviewed-fulltext-article-JMDH
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author Sung TC
Shih HI
Kawaguchi T
Chi CH
Hsu HC
author_facet Sung TC
Shih HI
Kawaguchi T
Chi CH
Hsu HC
author_sort Sung TC
collection DOAJ
description Tzu-Ching Sung,1 Hsin-I Shih,2– 4 Takeshi Kawaguchi,5 Chih-Hsien Chi,2,3 Hsiang-Chin Hsu3,6 1School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan; 2Department of Emergency Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan; 3Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 4Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 5Department of Emergency and Critical Care Medicine, St. Marianna University School of Medicine, Kanagawa, Japan; 6School of Medicine, College of Medicine, National Cheng Kung University, Tainan, TaiwanCorrespondence: Hsiang-Chin Hsu, Department of Emergency Medicine, National Cheng Kung University Hospital, National Cheng Kung University, No. 138, Shengli Road, North Dist, Tainan City, 704302, Taiwan, Tel +886-6-235-3535 ext. 4381 ; +886-919-157-167, Email i3593120@gmail.comBackground: Emergency department (ED) internships are essential for developing core clinical competencies in medical students. This study evaluates the weekly progression of key competencies during a structured three-week ED internship and examines the impact of extending the program from two to three weeks. Additionally, it considers how such training supports students’ readiness for multidisciplinary, team-based healthcare environments.Methods: This retrospective longitudinal study analyzed a total of 2068 workplace-based assessment (WBA) forms collected from June 2018 to May 2020. Each WBA evaluated ten key clinical competencies: learning attitude, history taking, clinical judgment, medical knowledge, prescription, communication, patient education, literature appraisal, oral presentation, and documentation. A subgroup of 133 medical students who completed the full three-week internship with complete WBA records was included in the longitudinal analysis. Generalized Estimating Equations (GEE) modeling assessed performance trends and inter-cohort differences between 2018 and 2019.Results: Significant improvements were observed across all competencies, with the most notable gains in history taking, clinical judgment, communication, prescription, and documentation. Learning attitude scores increased from 4.46 (SD = 0.66) in Week 1 to 4.58 (SD = 0.58) in Week 3. Prescription and documentation improved from 3.85 and 4.17 to 4.06 and 4.32, respectively. GEE analysis confirmed significant performance gains by Week 3 (p = 0.0064). Students in 2019 outperformed those in 2018 (p = 0.0318), suggesting that curriculum refinements enhanced educational outcomes.Conclusion: A structured three-week ED internship significantly enhances medical students’ clinical competencies, particularly in areas fundamental to multidisciplinary care such as communication, clinical judgment, and documentation. The extended duration promotes deeper clinical immersion and fosters skill reinforcement through real-time feedback and collaborative practice. These findings underscore the importance of sustained, structured clinical experiences in preparing students to function effectively within interdisciplinary healthcare teams. Further research should investigate optimal training durations and integrative teaching strategies to support competency-based, team-oriented medical education.Keywords: clinical competency progression, emergency training, medical internships, diagnostic reasoning, multidisciplinary care, medical education
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spelling doaj-art-1cd203be61a34f788fbec345488d3d932025-08-20T03:49:51ZengDove Medical PressJournal of Multidisciplinary Healthcare1178-23902025-07-01Volume 18Issue 138773890104575Tracking Clinical Competency Growth: A Longitudinal Study of Medical Students in a Multidisciplinary Emergency Department Internship ProgramSung TC0Shih HI1Kawaguchi T2Chi CH3Hsu HC4School of Medicine for International Students, College of MedicineDepartment of Emergency MedicineDepartment of Emergency and Critical Care MedicineDepartment of Emergency MedicineSchool of Medicine, College of MedicineTzu-Ching Sung,1 Hsin-I Shih,2– 4 Takeshi Kawaguchi,5 Chih-Hsien Chi,2,3 Hsiang-Chin Hsu3,6 1School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan; 2Department of Emergency Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan; 3Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 4Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 5Department of Emergency and Critical Care Medicine, St. Marianna University School of Medicine, Kanagawa, Japan; 6School of Medicine, College of Medicine, National Cheng Kung University, Tainan, TaiwanCorrespondence: Hsiang-Chin Hsu, Department of Emergency Medicine, National Cheng Kung University Hospital, National Cheng Kung University, No. 138, Shengli Road, North Dist, Tainan City, 704302, Taiwan, Tel +886-6-235-3535 ext. 4381 ; +886-919-157-167, Email i3593120@gmail.comBackground: Emergency department (ED) internships are essential for developing core clinical competencies in medical students. This study evaluates the weekly progression of key competencies during a structured three-week ED internship and examines the impact of extending the program from two to three weeks. Additionally, it considers how such training supports students’ readiness for multidisciplinary, team-based healthcare environments.Methods: This retrospective longitudinal study analyzed a total of 2068 workplace-based assessment (WBA) forms collected from June 2018 to May 2020. Each WBA evaluated ten key clinical competencies: learning attitude, history taking, clinical judgment, medical knowledge, prescription, communication, patient education, literature appraisal, oral presentation, and documentation. A subgroup of 133 medical students who completed the full three-week internship with complete WBA records was included in the longitudinal analysis. Generalized Estimating Equations (GEE) modeling assessed performance trends and inter-cohort differences between 2018 and 2019.Results: Significant improvements were observed across all competencies, with the most notable gains in history taking, clinical judgment, communication, prescription, and documentation. Learning attitude scores increased from 4.46 (SD = 0.66) in Week 1 to 4.58 (SD = 0.58) in Week 3. Prescription and documentation improved from 3.85 and 4.17 to 4.06 and 4.32, respectively. GEE analysis confirmed significant performance gains by Week 3 (p = 0.0064). Students in 2019 outperformed those in 2018 (p = 0.0318), suggesting that curriculum refinements enhanced educational outcomes.Conclusion: A structured three-week ED internship significantly enhances medical students’ clinical competencies, particularly in areas fundamental to multidisciplinary care such as communication, clinical judgment, and documentation. The extended duration promotes deeper clinical immersion and fosters skill reinforcement through real-time feedback and collaborative practice. These findings underscore the importance of sustained, structured clinical experiences in preparing students to function effectively within interdisciplinary healthcare teams. Further research should investigate optimal training durations and integrative teaching strategies to support competency-based, team-oriented medical education.Keywords: clinical competency progression, emergency training, medical internships, diagnostic reasoning, multidisciplinary care, medical educationhttps://www.dovepress.com/tracking-clinical-competency-growth-a-longitudinal-study-of-medical-st-peer-reviewed-fulltext-article-JMDHclinical competency progressionemergency trainingmedical internshipsdiagnostic reasoningmultidisciplinary caremedical education
spellingShingle Sung TC
Shih HI
Kawaguchi T
Chi CH
Hsu HC
Tracking Clinical Competency Growth: A Longitudinal Study of Medical Students in a Multidisciplinary Emergency Department Internship Program
Journal of Multidisciplinary Healthcare
clinical competency progression
emergency training
medical internships
diagnostic reasoning
multidisciplinary care
medical education
title Tracking Clinical Competency Growth: A Longitudinal Study of Medical Students in a Multidisciplinary Emergency Department Internship Program
title_full Tracking Clinical Competency Growth: A Longitudinal Study of Medical Students in a Multidisciplinary Emergency Department Internship Program
title_fullStr Tracking Clinical Competency Growth: A Longitudinal Study of Medical Students in a Multidisciplinary Emergency Department Internship Program
title_full_unstemmed Tracking Clinical Competency Growth: A Longitudinal Study of Medical Students in a Multidisciplinary Emergency Department Internship Program
title_short Tracking Clinical Competency Growth: A Longitudinal Study of Medical Students in a Multidisciplinary Emergency Department Internship Program
title_sort tracking clinical competency growth a longitudinal study of medical students in a multidisciplinary emergency department internship program
topic clinical competency progression
emergency training
medical internships
diagnostic reasoning
multidisciplinary care
medical education
url https://www.dovepress.com/tracking-clinical-competency-growth-a-longitudinal-study-of-medical-st-peer-reviewed-fulltext-article-JMDH
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