INTERNSHIP CLINICAL PERFORMANCE OF CLINICAL OFFICERS IN SELECTED HOSPITALS IN WESTERN KENYA

Internship is at the epicentre of skill development by clinical officers prior to full time employment. There have been challenges befalling the clinical performance from the newly graduated clinical officers. Clinical internship being the transitional period to enhance clinical officers’ competencies this has been challenging to new clinical officers. It is important for clinical officers to master taking of patient’s history, performingphysical examination, making diagnosis and offering treatments. However, this is still challenging to newly graduated clinical officers. Therefore, this study was conducted to investigate the clinical performance of newly qualified clinical officer interns during internship at Kakamega, Bungoma and Webuye hospitals, Kenya. Descriptive cross-sectional research design was used and a Census method was employed to obtain 100 respondents through a structured questionnaire. A pre-test was done with validity established through crosschecking and reliability calculated using the Cronbach method (0.741). Using a statistical package for social sciences version 25, descriptive and inferential statistics was run. Correlation was performed to ascertain the association of the factors contributing to clinical performance of newly graduated clinical officers at workplace. Results: level of clinical performance by the clinical officer interns was rated above average by the supervisors. This indicated that clinical officer interns exceeded the threshold as per the supervisor’s score in the COC’s logbooks. The level of clinical performance of clinical officer interns indicated a strong positive association;participation in history taking (r = 0.745), case presentations (r = 0.683), decision making (r = 0.745), plan of management (r = 0.900), ethical decision making (r = 0.900), professionalism (r = 0.816) and therapeutic procedures (r = 0.816). The number of the training institutions had skills laboratories (86.1%) though about half of them were not fully functional. On course content, teaching strategies and relevance of knowledge acquired to current clinical performance were rated by CO interns as adequate(50%). The learning environment, relevance to internal rotational assessment and internship booklet were rated above 50%. Skills laboratorywas equipped and functional and therefore showing a strong positive association with course content (r = 0.845), teaching strategy (r = 0.920), previous learning environment (r = 0.920, relevant knowledge acquired applicable in workplace (r = 1.000) and medium positive association with assessment of competencies from internship booklet (r = 0.642). In conclusion for the maintenance of clinical performance of clinical officer interns at high levels and achievement of the quality health care, the clinical officers training curricula should reflect a competent clinical officer working in a complex health system in order to develop a variety of professional skills which should be innovative. The innovations should guide the shift from following a set of standards to curricula based on competencies or practice outcomes. This therefore means that, innovative strategies should be embraced and interprofessional collaboration during training beembraced.The adoption of mentorship and preceptorship model of training and use of cooperation between the institution and the faculty to improve competencies of the clinical officer interns. Recommendation: Kenya clinical officers associations, a professional body together with COC and the ministry of Health policy making body should plan on how they can address the issue of motivation and harassment.