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Postgrad Med J. 2017 Oct;93(1104):592-596. doi: 10.1136/postgradmedj-2016-134718. Epub 2017 May 12.

Closing the theory to practice gap for newly qualified doctors: evaluation of a peer-delivered practical skills training course for newly qualified doctors in preparation for clinical practice.

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Network for Improving Critical Care Systems and Training, Colombo, Sri Lanka.
Mahidol Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand.
University of Oxford, Oxford, United Kingdom.
Lady Ridgeway Hospital, Colombo, Sri Lanka.
Faculty of Medicine, University of Rajarata, Anuradhapura, Sri Lanka.
Government Medical Officers Association, Colombo, Sri Lanka.
National Intensive Care Surveillance, Ministry of Health, Colombo, Sri Lanka.
Intensive Care National Audit and Research Centre, London, UK.
Critical Care Research Team, Royal London Hospital, London, UK.
William Harvey Institute, Queen Mary University of London, London, UK.
Education, Training and Research Unit, Ministry of Health, Colombo, Sri Lanka.
Director General of Health Services, Ministry of Health, Colombo, Sri Lanka.
National Hospital of Sri Lanka, Colombo, Sri Lanka.
Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.



The Good Intern Programme (GIP) in Sri Lanka has been implemented to bridge the 'theory to practice gap' of doctors preparing for their internship. This paper evaluates the impact of a 2-day peer-delivered Acute Care Skills Training (ACST) course as part of the GIP.


The ACST course was developed by an interprofessional faculty, including newly graduated doctors awaiting internship (pre-intern), focusing on the recognition and management of common medical and surgical emergencies. Course delivery was entirely by pre-intern doctors to their peers. Knowledge was evaluated by a pre- and post-course multiple choice test. Participants' confidence (post-course) and 12 acute care skills (pre- and post-course) were assessed using Likert scale-based questions. A subset of participants provided feedback on the peer learning experience.


Seventeen courses were delivered by a faculty consisting of eight peer trainers over 4 months, training 320 participants. The mean (SD) multiple choice questionnaire score was 71.03 (13.19) pre-course compared with 77.98 (7.7) post-course (p<0.05). Increased overall confidence in managing ward emergencies was reported by 97.2% (n=283) of respondents. Participants rated their post-course skills to be significantly higher (p<0.05) than pre-course in all 12 assessed skills. Extended feedback on the peer learning experience was overwhelmingly positive and 96.5% would recommend the course to a colleague.


A peer-delivered ACST course was extremely well received and can improve newly qualified medical graduates' knowledge, skills and confidence in managing medical and surgical emergencies. This peer-based model may have utility beyond pre-interns and beyond Sri Lanka.


acute care; clinical skills; education and learning; patient safety; peer learning

[Indexed for MEDLINE]

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