This summer I stumbled upon an amusing entry on CNN.com from Anthony Youn, M.D., a plastic surgeon in Metro Detroit. He is the author of “In Stitches,” a humorous memoir about growing up Asian American and becoming a doctor.

In his post, he talks about “The July Effect” - something Challenger is actively addressing. Dr. Youn writes:

A recent study published by the Journal of General Internal Medicine reported a 10 percent spike in teaching hospital deaths during the month of July due to medical errors. We call this spike “The July Effect” and we attribute it to the influx of new interns and residents.

Typically, medical students graduate in June and begin their first year of residency training — internship — in July. This group of eager new interns invades the hospital to learn, care for patients, and make medical decisions. One problem. They don’t know what they’re doing.

Like most interns, I arrived with four years of medical school under my belt, an M.D. after my name, and virtually no practical knowledge of medicine. Although I wore the long white coat of a doctor, I kept my pockets packed with condensed medical manuals that we called our “peripheral brains” to make up for the lack of knowledge held in my actual brain. Thank God for these manuals. Otherwise I would have been part of “The July Effect.”

You can continue reading his original post here, but my interest in this story was what can be done about the so called July Effect. Obviously learning your way around a new facility, new personalities, new hierachies, and new systems is one thing, but what about establishing some sort of baseline of clinical knowledge on these incoming residents?

That’s something that can be provided through a clinical knowledge testing system – something that can provide a straight exam to residents BEFORE they start their shifts. Every one will have different strengths, but how do you know them? How do you know that Bill is much more likely to kill a patient in cardiac arrest than Sally? An apples to apples assessment of their comprehensive knowledge might not solve everything, but the data alone can help attendings and faculty know who-needs-what this July. Thankfully, this is something that can be done.

In the four years Challenger has been implementing adjunct e-learning systems at residencies and PA training institutions to provide comprehensive training and evaluation. Our results indicate a 10% jump in in-training exam scores and a faster uptick in test scores and practical knowledge from day one of training as compared to instutions without adjunct e-learning applied to clinician learners.

Bobby Anderson
CCO, Challenger Corp