Construction of a self-assessment tool for the readiness of pharmacy departments for internship teaching in public healthcare organizations-An Exploratory Mixed Study

Construction of a self-assessment tool for the readiness of pharmacy departments for internship teaching in public healthcare organizations-An Exploratory Mixed Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Construction of a self-assessment tool for the readiness of pharmacy departments for internship teaching in public healthcare organizations-An Exploratory Mixed Study Huitao Huang, Zhao Yin, Jiayi Du, Wan Zhang, Xuedong Jia, Shuai Jiang, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4222246/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 11 Oct, 2024 Read the published version in BMC Medical Education → Version 1 posted 10 You are reading this latest preprint version Abstract Objectives : Internship in the pharmacy department of medical institutions is an important stage in the growth of pharmacy students. However, the level of internship teaching in pharmaceutical departments of medical institutions in China is not uniform at present, and there is a lack of corresponding readiness evaluation tools. Therefore, the purpose of this study was to construct a self-evaluation tool for the readiness of pharmacy departments in healthcare organizations and to evaluate the readiness of pharmacy departments in healthcare organizations in all aspects of internship teaching. Methods : This study was conducted using an exploratory mixed approach and was completed in two phases. In the first stage, qualitative research methods were used to conduct semi-structured interviews with hospital pharmacy interns and internship instructors, respectively, in the form of one-on-one or focus groups. The interview data were analyzed by using the theme analysis method to obtain a collection of self-evaluation indicators of internship and teaching readiness in the pharmacy department of public medical institutions. Then, on the basis of literature research, the first draft of the self-assessment tool for internship and teaching readiness in the pharmacy department of medical institutions was compiled. In the second stage, the Delphi method was used to screen the evaluation indexes, a self-evaluation tool for the readiness of the pharmacy department was constructed, and the experts were allowed to score the current status of the internship and teaching in the pharmacy department of medical institutions in China. Results : The qualitative research results of the first phase include 5 themes and 22 sub-themes, which serve as the source of indicators for self-assessment tools. In the second stage, the effective recovery rates of the two rounds of expert letters were 90.48% and 89.47% respectively, the expert authority coefficient was 0.779. The self-assessment tool for the readiness of pharmacy departments of healthcare institutions for teaching internships was constructed to include readiness for teaching internships' organization, readiness for teaching internships' content, readiness for teaching internships' modes, readiness for evaluating internships' effects, and readiness for emergency management of internships. The self-assessment tool includes 5 dimensions and 35 secondary indicators. The experts rated the preparedness of pharmacy departments of medical institutions in China in terms of preparedness for teaching internships differently. The score for the preparation degree of emergency management of internship teaching is the highest, the score for organizational structure and teaching content preparation of internship teaching is higher, while the score for the preparation degree of internship teaching mode and teaching effect evaluation is lower. Conclusion : The self-assessment tool of the readiness of pharmacy departments in medical institutions to teach internships is scientific and practical and provides a reference basis for the development of the internship teaching program of pharmacy departments in medical institutions. Internship Pharmacy departments Readiness Mixed study Figures Figure 1 Figure 2 Figure 3 INTRODUCTION Internships in medical institutions are crucial for pharmacy students. During this practical stage, students enhance their hands-on skills and apply theoretical knowledge to real-world tasks, such as dispensing medications and providing drug consultations. It serves as a pivotal period for students transitioning from pharmacy academics to the role of hospital pharmacists. Through practical experience, they gain a better understanding and adaptation to the requirements of pharmaceutical services in hospitals, preparing them for future involvement in comprehensive pharmaceutical care [1] . Moreover, medical institution internships offer comprehensive career preparation, fostering communication with patients and healthcare professionals, as well as cultivating teamwork and other essential competencies. Accumulating internship experience allows students to delve deeper into the operational aspects of medical institutions and the needs of patients, laying a solid foundation for delivering personalized pharmaceutical services [2] . In summary, internships in medical institutions provide valuable hands-on opportunities for pharmacy students, establishing a critical foundation for their future professional development. Public medical institutions serve as the primary venues for pharmacy student internships, undertaking significant teaching responsibilities for pharmaceutical interns [3] . Moreover, the internship programs, content, modes, and expertise of teaching staff in medical institutions significantly impact the effectiveness and satisfaction of internships. Currently, there is a lack of precise self-assessment tools in China for evaluating the preparedness of pharmaceutical departments in medical institutions for internships, highlighting the need for attention to this issue. Therefore, establishing appropriate self-assessment tools is crucial for enhancing internship quality and satisfaction. Evaluating the readiness of internship mentoring in pharmaceutical departments of medical institutions has been a focal point in international research. Key assessment factors encompass mentor qualifications, teaching resources, the practicality of internship courses, comprehensive internship arrangements, effective evaluation tools, and feedback mechanisms, and fostering collaborative relationships. Through methods such as surveys, interviews, observations, and communication with interns, ensuring that medical institutions provide high-quality and comprehensive training experiences is crucial for enhancing interns' capabilities and professional competence. Zhao et al. [4] reported tools for assessing interns' training experiences, such as the "Postgraduate Hospital Educational Environment Measure (PHEEM), Perceived Stress Scale (PSS), General Health Questionnaire-12 or 30 (GHQ-12 or GHQ-30), Patient Health Questionnaire-9 (PHQ-9), and Maslach Burnout Inventory (MBI)." PHEEM consists of three subscales: role autonomy, teaching, and social support, with 40 questions addressing specific aspects of the educational environment. Despite extensive international research on internship mentoring experiences, including qualitative studies, surveys of interns, and evaluation tools, a universally accepted assessment tool is still lacking. Similarly, domestic scholars in China have explored the hospital pharmacy internship mentoring model, discussed challenges and solutions, and summarized mentoring teachers' experiences [5-9] . Currently, there is a gap in evaluating the readiness of pharmaceutical departments in Chinese medical institutions for internship mentoring. Compared to the over 60-year development of hospital pharmacy education in the United States, China initiated pharmacy internship mentoring relatively late, initially focusing on training programs. From 1980 to 1982, institutions such as Shanghai Medical University (now part of Fudan University School of Medicine), China Pharmaceutical University, and West China Medical University organized clinical pharmacy training courses to cultivate key personnel in clinical pharmacy. In 1993, the Ministry of Health established a Clinical Pharmacy Training Center at the School of Pharmacy at Shanghai Medical University to train clinical pharmacy professionals nationwide. In November 2005, the Ministry of Health issued notices and plans to pilot clinical pharmacist training programs, outlining the purposes, goals, content, funding, timing, and management of the training initiatives, exploring models for clinical pharmacist development, and related policies [10, 11] . In recent years, with the rapid development of China's hospital pharmacy sector, relatively mature internship mentoring systems have gradually formed in some large comprehensive tertiary hospitals [12] . In Beijing, the clinical practice and standardized training for hospital pharmacists after graduation are divided into two stages. The first stage, known as the general pharmacist training phase, covers six key skills: prescription review and dispensing, drug dispensing, medication consultation, adverse reaction reporting, pharmacy management, and drug quality management. The second stage, the clinical pharmacist training phase, focuses on six skills: ward rounds, consultations, discussions on challenging cases, information intelligence, patient education, and medication history documentation. The PLA General Hospital categorizes trainees into seven levels: clinical pharmacist instructor trainees, clinical pharmacist trainees, hospital pharmacist trainees, pharmacy graduate students, pharmacy undergraduate students, pharmacy continuing education students, and pharmacy professionals. Targeted common and personalized training goals are established, ensuring that individuals across categories master basic pharmacological effects, adverse reactions, and the hospital pharmacy workflow, While observing the current methods and content of pharmacy internship mentoring in China, several issues persist. These include the lack of national operational guidelines, the absence of systematic internship mentoring plans, a shortage of authoritative evaluation tools for internship effectiveness, and inconsistent training programs among various medical institutions [13] . Additionally, the approach to interns differs from that in foreign countries, where interns are mainly recruited with certain admission standards, receive paid internships, and have a more structured hierarchy. In contrast, Chinese medical institutions' pharmacy departments accept interns from different educational levels, including diploma, bachelor's, and master's degrees, leading to distinct challenges in internship mentoring. Therefore, developing a self-assessment tool for the readiness of pharmaceutical departments in Chinese medical institutions for internship mentoring holds significant importance in addressing the unique circumstances of the country. Before this, we used qualitative research methods to understand the experience and suggestions of both supply and demand on pharmaceutical practice in medical institutions from the perspective of interns and teachers. The interns who participated in the study mentioned the negative experiences of the internship process and reflected that there are still imperfections in the current pharmacy internship in China, such as insufficient clinical faculty ability, unreasonable internship mode, and unscientific internship content [13] . Similarly, the teacher also pointed out the problems existing in the practice teaching in our country, such as the lack of systematic practice teaching program; The content and mode of practice teaching lack of uniform standards; Lack of assessment of intern's clinical practice ability; There is also a lack of scientific and effective evaluation tools [14] . Therefore, based on the previous research, this study intends to carry out exploratory mixed-method research from the perspective of the supply side and combined with China's national conditions. The advantage of this approach is that it combines the advantages of qualitative and quantitative research, but also compensates for the shortcomings of each other [15] . The following research objectives are to be achieved: 1) to construct a self-evaluation tool for practice teaching readiness of pharmaceutical departments in medical institutions. 2) preliminary evaluation of the preparation of practice teaching in pharmaceutical departments of medical institutions. METHODS Ethical approvals Ethics was approved by The First Affiliated Hospital of Zhengzhou University Institutional Review Board approved the protocol (2019-KY-304). Written informed consent was obtained from all the study participants. Study Design In this paper, an exploratory mixed method was adopted for research [16] . In the first stage, an indicator pool was formed based on semi-structured interviews, and the first draft of the self-assessment tool for internship and teaching readiness of pharmaceutical departments in medical institutions was compiled based on the results of the literature review. The second stage: the Delphi method was used to select evaluation indexes, and the self-assessment tool of internship teaching readiness in the pharmacy department was constructed and optimized. We reported the entire mixed-methods study according to the Good Reporting of a Mixed Methods Study (See Appendix 1), the research ideas of this paper are shown in Figure 1. Phase I : qualitative study Participants The inclusion criteria for interns are: 1. Willing to participate in this study 2. Internship in the hospital for at least three months 3. Completion of at least three years of study in the School of Pharmacy. The selection criteria for teaching teachers are: 1. Willing to participate in this study 2. Have rich work experience, intermediate title or above 3. Have teaching experience as an intern. Data Collection Focus group interviews were conducted with interns from three large top three teaching hospitals in Henan Province (the first affiliated Hospital of Zhengzhou University, the third affiliated Hospital of Zhengzhou University, and the People's Hospital of Henan Province) from February 2021 to June 2021. From three large-scale top three general hospitals in China (The First Affiliated Hospital of Zhengzhou University - Henan Province. Zhengzhou; the First Affiliated Hospital of Sun Yat-sen University - Guangdong Province. Guangzhou; Sichuan Provincial People's Hospital - Sichuan Province. Chengdu) conducted a series of interview studies from January 2022 to March 2022. Before the beginning, the researchers introduced the background and purpose of the study to the selected tutors and interns. After obtaining the informed consent of the participants, the interview was conducted by one researcher and recorded by another researcher. The whole process was recorded. Data saturation was defined as “no new themes or codes emerging from interviews”. Finally, 16 interns and 14 teachers participated in this qualitative study. Data Analysis Interview data were analyzed using thematic analysis, a method widely used in qualitative research to identify, analyze, and report data patterns. Key steps in the topic analysis include familiarity with data, generating initial code, searching and reviewing topics, naming topics, and generating final reports, The researchers transcribed the recordings within 24 hours, using NVivo12 to manage and analyze the data. The two researchers independently extracted the code and wrote the first draft of the topic and subtopics. Subsequently, the research group discussed the first draft of the theme and sub-theme, and put forward opinions and suggestions on the topic structure and language expression, and the final theme and sub-theme were formulated with the consent of the research group, and the appropriate representative citations were selected to present the theme or sub-theme. The qualitative report follows the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist (see Appendix 2). Phase II : qualitative study The Delphi method The Delphi method is a widely used methodological tool for building group consensus, where consensus is reached through multiple rounds of questionnaires providing group opinions with individual feedback. Experts fill out the questionnaires anonymously without discussing them with each other, which has a certain degree of subjectivity, so the selection of representative experts is the key to the implementation of the Delphi method, which determines the authority, scientificity, and validity of the findings of the study. [17, 18] Establishing of the expert panel The Delphi method generally requires the selection of experts to be authoritative and representative professionals in the relevant fields, and the number of 15 to 50 is preferable. [19] The selection criteria for this study were: (1) tertiary hospitals with more than 5 years of experience in the specialized field of hospital pharmacy; (2) willingness to cooperate in completing multiple rounds of expert correspondence. On the basis of a comprehensive analysis of qualitative research results and literature review, the group discussed and finalized the first draft of the expert correspondence form containing 5 primary indicators and 37 secondary indicators. The first draft of the expert correspondence form was finalized after discussion by the group [20] . The first draft of the expert consultation questionnaire consists of three parts, the first part is the general information about the experts: age, years of experience, education, title, etc.; the second part is the self-assessment tool for self-assessment of the readiness of the pharmacy department of the health care institution to teach internships Indicator Importance Evaluation Scale, which evaluates the importance of the indicators using a Likert five-point scale, with 5=very important, 4=important, 3=generally important, 2=unimportant, and 1=not important at all, and provide a suggestion column; Part III Indicator Judgment Basis Table: expert scores for familiarity with survey content and indicator judgment [21] . In this paper, two rounds of expert correspondence were conducted in strict accordance with the Delphi method, with pre-surveys before the correspondence, and timely modification and improvement of problems to ensure the validity of the questionnaire and its operability. Cognitive interviews were conducted with two experienced teachers from the pharmacy departments of healthcare organizations before each correspondence. In the presence of the research team, the teachers read out the questions aloud stated their own understanding, and selected the options they thought were appropriate, in order to gain a deeper understanding of the problems in the questionnaire and make timely modifications and improvements, so that the results of the survey would be more reliable [22] . In June-August 2023, the online survey was implemented using the online platform Questionnaire Star (Changsha Ranxing Information Technology Co., Ltd), a widely used free online questionnaire platform in China. Firstly, we introduced the study background to the experts and obtained informed consent, the experts rated the indicators and suggested modifications. We collated and summarized the experts' opinions, designed a second round of questionnaires, and consulted the experts again on whether they agreed to delete the indicators with significance means 0.25, and asked the experts to rate the current organizational structure of the pharmacy departments of medical institutions in China in terms of the organizational structure of internship tutoring, the content of internship tutoring, the mode of internship tutoring, assessment of internship tutoring effects, and emergency management of internship tutoring [23] . both questionnaires were provided as supplementary materials (Appendices 3 and 4). Analysis Excel and SPSS software were used to process the results of the questionnaire and statistically analyze the arithmetic mean, standard deviation, coefficient of variation, and Kendall's coordination coefficient of the importance of each indicator. The questionnaire recovery rate represents the positive degree of experts; the coefficient of expert authority (Cr) is the average of the expert's familiarity with the indicators (Cs) and the coefficient of indicator judgment (Ca) [24] ; the degree of harmonization of experts' opinions is represented by the coefficient of variation and Kendall's harmonization coefficient. RESULTS Demographic Characteristics The first phase of the qualitative study involved 16 interns and 14 teachers. The average age of the 16 interns was 21 years old, and the duration of the internship was more than 6 months, their demographics are shown in Table 1. The average age of the 14 teachers was 36.1 years and the average length of service was 11.3 years, their demographic data are shown in Table 2. Table 1:Demographic Characteristics of 16 interns Characteristics Value Gender,n Male Female Age, years Mean (range) Median Major Number of departments rotated, n 1department 2-3 department 4-6 department Intership duration, n 6 months 7 months 8 months 1 15 21(20-24) 21 Pharmacy 2 8 6 4 2 10 Table 2:Demographic Characteristics of 14 teachers Characteristics Mean (SD) or n (%) Gender Male Female Age, mean （SD） Working years, mean(SD) Title Intermediate level Associate Advanced level Advanced level Number of interns taught（number） 1-4 5-10 >10 6（42.86） 8（57.14） 36.1（6.2） 11.3（7.44） 9（52.63） 7（42.11） 1（5.26） 3（21.43） 8（57.14） 3（21.43） In the second phase of the quantitative study, 19 of the 21 invited experts responded to the questionnaire in the first round of the Delphi correspondence. In the second round of the Delphi Correspondence, 17 of the 19 invited experts answered the questionnaire. The basic information of the experts interviewed by the two letters is shown in Table 3. Table 3:Demographic Characteristics of the experts who participated in the two rounds of correspondence Characteristics QR1 n (%) QR2 n (%) Gender Male Female Age(years) 50 Work experience in pharmacy (years) 4–9 10–19 20–29 30–39 Title Intermediate level Associate Advanced level Advanced level 8（42.11） 11（57.89） 13（68.42） 5（26.32） 1（5.26） 10（52.63） 7（36.85） 1（5.26） 1（5.26） 10（52.63） 8（42.11） 1（5.26） 7（42.11） 10（57.89） 12（68.42） 4（26.32） 1（5.26） 9（52.63） 6（36.85） 1（5.26） 1（5.26） 9（52.63） 7（42.11） 1（5.26） Qualitative Results The qualitative research in the first stage finally extracted 5 primary themes and 22 sub-themes, as shown in Figure 2. The five first-level themes are the organizational structure of practice teaching, the content of practice teaching, the mode of practice teaching, the evaluation of practice teaching effect, and emergency management of practice teaching. Results of the qualitative study for themes, sub-themes, and representative quotations are in Table 4. Code G1P1-G2P3, P1-P7 for the teacher, G3P1-G5P5 for the intern. Table 4: Results of the qualitative study for themes, sub-themes, and representative quotations Category Code Description Organizational structure of internship Hardware and facilities for internship (G5P3) There are just too many people there, there's limited space in the lab, and the students who go there can't possibly say that if you're interested, you can go to that kind of thing.... (G5P2) The mass spectrometer we have there are just so many students sitting there... I couldn't even get into the room... Later, when that student came to me, there was no room for us to sit... Detailed internship syllabus or manual (G1P1) Then according to different specialties, there are different requirements, that is, for what you need to master the theoretical knowledge, what kind of clinical practice skills are a target requirement. So we have a basic syllabus to teach. Internship management rules and regulations (G2P1) ... It will also include organizational management, which is training in day-to-day work management. That is, when you go to work when you go off work, and then when you should obey the substitute teacher. And then there will be such a training, and then there is also leave, this is more critical, can not move leave, leave of absence of a management system training Individualized teaching programs (P5) I think it is important to first of all, according to the intern's position, that is, he may be a specialist, and the undergraduate of his foundation is not the same, he needs to master this is not particularly the same. Internship teaching content Pre-job training (induction training) (G2P2) When the students come over, I will do a half-hour to one-hour induction training. The main content is the distribution of our hospital, which is the basic information of the hospital, and then the basic information of the pharmacy department, because our pharmacy department may have more than ten departments in its management structure. The students may not be able to understand it, and then I will give them basic training. Detailed internship syllabus or manual (P7) I would give them a detailed, this is the plan for the internship. It's just generally specific to the point where it would be specific to the week, it's every week, and roughly what's going to be covered would be listed out for him. Content and workflow of pharmacy work (G2P2) For us it would be required, for example, in emergency medicine, then you would have to teach at least two per month, interns. We said then the content of this course should be related to the day-to-day work of our emergency medicine transfers. And then this is some of the systems, and then the basic processes, and some of the job specifications. Practical skills training (P5)Then, in the outpatient department, you have to tell the patient what precautions there are for this medicine... (P4) in addition, you can also give patients medication education... Training in core competencies (G1P1) One of the main enhancement skills is the ability to review the literature and then organize it and summarise it... (G1P3)... This communication skill of yours, actually I think it's as important as the professional course... (G5P2) I think that on the one hand, it's developed my self-learning skills. Professional orientation and ethics training (P5) As an instructor, when you come into contact with the interns, you hope that they will make a lot of progress, or have a preliminary understanding of the direction of their future work... For example, the direction of pharmacists now is to have more contact with patients... (G4P2): It may give us some direction, there may be more choices after graduation to see which one they are suitable for... Internship and teaching mode Intern's needs and learning abilities (G1P4) I think because frankly a variety of banding models, for an undergraduate intern, what kind of banding model does he need? I think it probably goes to the root of what kind of needs he has. Right? (G5P3) It should still depend on the individual, we were here when Mr.Pao told us that although it was mainly a sub kind of thing, it still allows you to choose on your own, and then after you've chosen it, the teacher in then adjusts it according to the real situation of each department. Teaching model combining theory and practice (G1P3) A model of practice leading... We focus very much on the practical aspect of it... Length of internship (P3). One problem is that lies in the fact that it's because some of the students who come to study have a long time, some have a short time, and the question of the length of time, yes, the question of the length of time, actually has a big impact on this for us. Because if it's a short time, even though this is the piece of him that I've trained him well, he's going to switch subjects soon. And then for me, I spend a lot but the student actually can't fully grasp what the teacher is teaching. Certain degree of freedom in their time (P7)... Then after coming to us, that is, we have relatively large degrees of freedom then, he may not have, not yet adapted (G4P3).... People do want to specialize in this, learning is also quite good, specializing in this pressure is also quite big is special, just want to have a little more time to learn, you can negotiate it! Evaluation of the effectiveness of internship Meets the internship needs (P7)... We will display our research directions one by one, and then let the students look at them and introduce them, and then see if they are interested in the direction of their graduate studies or if they are interested in their interests, and then we will let the teachers communicate with them after you have selected them. If you feel that they are a good match, then they will be assigned to the appropriate content of the subject group. IEquipped with basic knowledge (P1) There was a student from the Railway Institute of Vocational Technology, and when you asked him about antibiotics, cephalosporins, generation one, generation two, and generation three, he didn't know, these are the most basic, the simplest, and he didn't understand even when he asked him... Are you unable to teach him, how do you teach him... (G3P2) I think my truest feeling is that my knowledge is too little. The knowledge base is too little. I feel like I don't know anything since I've been here. Evaluations of the internship process (G1P3) Process assessment vs. In fact, our question paper is only for the final examination, it is a stage examination... Yes, and then the process assessment is actually like the medication education guide that I just mentioned or the medical advice pharmacy consultation. This is because it will be carried out every day... Finally the process of stopping clinical practice, you'll see that he's crossed the line. Two-way assessment (G2P1) We kinda accept that two-way assessment ..... The two-way, it includes the teacher's consideration of the student, then our department's consideration of the student, the hospital's consideration of the student, and in turn, the student's consideration of the instructor, the student's consideration of the department in which he's rotating. .... And then as well as the management of our department, he is in the pharmacy department, an evaluation of the pharmacy department, and even an evaluation of the entire management of the hospital. Theoretical examinations and clinical practice (G1P1) And then there's also the paper that's specifically for interns... And then there's a paper for interns to improve their theoretical knowledge and professional skills. (G1P2) For clinical pharmacists, it's generally theory, right? And then there's also a skills test. Theoretical examinations and clinical practice Contact information for each other (G1P1).... And also with his guidance counselor and the group leader, anyway, all the various students went to contact him, and he couldn't be contacted at home, including his parents, because he switched off his phone .... Then it was very anxious, yes, it was very anxious. Emergency plans for safety and health (G1P1) Then I asked their group leader, I said why this student didn't come to class, and then the group leader said he didn't know, and then later on he asked them to contact this student, and it turned out that no one could find him... That process was really too, too scary (P3) But I, if you have anything, anything, you have to take leave from me. Yeah, and then we're still responsible for your safety here. There are two-way feedback channels (G2P3) During the training in the admission to the department, they will be told that if they have any problems in the course of their daily internship, they can first react to the departmental team leader, for example, Mr Ren, or Mr Yuan. If you think it's not good to communicate, you can come back to me, I'll deal with it, I'll communicate, will give them that (P2)... We have to communicate promptly, that is, you have to it's quite normal that the problem is not resolved. But when you communicate, I know what you have probably worked on, and what are your interests in this area. Quantitative Results In this study, the authority coefficient of experts is 0.779, close to 0.80, which indicates that the experts participating in this study have a high degree of authority, The Kendall coordination coefficient of the primary index was 0.216, P<0.001; the Kendall coordination coefficient of the secondary index was 0.172, P<0.001, and the evaluation results of the indicators by the experts have consistency, which have laid a good theoretical foundation for the quality and reliability of the construction of the indicator system. Questionnaire round 1 (QR1) In the first round, four experts proposed amendments, one of whom suggested deleting "3.4 Whether interns have some freedom of time". The other three experts proposed language changes to four indicators, suggesting that the first level indicator "the degree of preparation of content for teaching internships" be changed to "Preparedness of content for teaching internships", and that the second level indicator "2.1 Whether interns are provided with training in vocational orientation and professional ethics in order to enhance interns' awareness of the specialty and their future career planning" be changed to "Whether interns are provided with vocational orientation and professional ethics training ". The indicator "2.2 Whether to provide interns with career orientation and professional ethics training to enhance their awareness of the specialty and their future career planning" was changed to "The content of the pre-service training is well developed, including an introduction to the relevant pharmacy rules and regulations of the hospital and the department, the management rules for interns, and an introduction to the departmental settings and functions of the department" ."4.5 Whether there is a dynamic assessment of the internship process should be changed to Whether there is a regular or periodic evaluation of the internship process".One of the experts suggested that "some secondary indicators have the phenomenon of multiple questions in one entry, which is not in line with the basic principle of entry design", and after discussion by the panel, it was decided to change "2.10 Whether there is a teaching internship for clinical pharmacists specializing in prescription review, formulation of pharmacy monitoring plan, clinical medication guidance, rational medication evaluation, etc." to "2.10 Whether there are teaching internships of specialized skills for clinical pharmacists"; 2.11 Whether interns are trained in core competencies such as communication skills, clinical thinking skills, research thinking skills, independent learning skills, critical thinking, etc. was changed to 2.11 whether interns are trained in the core competencies of pharmacists". The mean, standard deviation, and coefficient of variation of each indicator were calculated by scoring the importance of the indicator by experts. The mean value of the primary indicator "preparedness for emergency management of internship teaching" and five secondary indicators (1.7; 3.4; 4.1; 4.2; 4.4) was 0.25, so the experts were consulted again to see if they would agree to their deletion. Questionnaire round 2 (QR2) In the second round, there was a consensus of expert opinion. Agreed with the language changes proposed in Round 1 for Level 1 Indicator Internship Teaching Content Readiness and Level 2 Indicators 2.2, 2.10, 2.11, and 4.5, and disagreed with the language change for 2.1. All experts agreed to delete 1.7 and 3.4 and suggested retaining the primary indicator of preparedness for emergency management of internship teaching and the secondary indicators 4.1、4.2 and 4.4. After two rounds of correspondence inquiry, a self-evaluation system of emergency management readiness of practice teaching is formed, which includes 5 first-level indicators and 35 second-level indicators, as shown in Table 5. Table 5: Results of the first and second rounds of correspondence Importance rating of indicators Ratings the readiness in various areas Primary and secondary indicators Mean SD CV Mean SD 1. Readiness of the organizational structure for teaching internships 4.632 0.684 0.148 1.1 Whether there are sound rules and regulations for internship management 4.684 0.671 0.143 89.412 10.880 1.2 Availability of relevant hardware and facilities in line with internship leading 4.526 0.612 0.135 88.824 12.187 1.3 Availability of an internship leadership team 4.421 0.692 0.157 86.471 15.387 1.4 Availability of a selection program for lead teachers 4.105 0.809 0.197 81.176 19.648 1.5 Availability of job descriptions for lead teachers 4.158 0.688 0.166 78.235 18.787 1.6 Availability of a detailed internship lead syllabus or handbook 4.632 0.597 0.129 84.706 18.748 1.7 Availability of individualized teaching programmes tailored to the needs of the students*a 3.737 0.933 0.250 63.529 30.402 1.8 Whether the lead teacher receives regular training in relevant teaching and pharmacy service training 4.368 0.761 0.174 77.647 18.884 2. Teaching content readiness of internship*b 4.789 0.419 0.087 2.1 Whether interns are provided with vocational orientation and professional ethics training*b 4.526 0.772 0.171 75.294 19.722 2.2 The content of the pre-service training is well developed, including an introduction to the relevant pharmacy rules and regulations of the hospital and the department, the management rules for interns, and an introduction to the departmental settings and functions of the department*b 4.474 0.841 0.188 87.647 11.472 2.3 Whether there is a detailed time schedule and teaching plan for the progress of internship teaching in the internship teaching department 4.474 0.612 0.137 84.118 12.277 2.4 Availability of training in hospital pharmacy job content and workflow 4.526 0.772 0.171 90.588 11.440 2.5 Availability of medicines dispensing skills, management skills and practices 4.421 0.838 0.189 88.824 13.639 2.6 Availability of medication counseling and medication instruction skills and practices 4.263 0.806 0.189 78.824 19.001 2.7 Availability of pharmacy information technology operating system learning 4.263 0.933 0.219 75.294 22.394 2.8 Availability of PIVAS job profile learning 4.053 0.970 0.239 81.176 14.090 2.9 Availability of training on adverse drug reaction management and reporting process 4.053 0.970 0.239 80.588 24.102 2.10 Whether there are teaching internships of specialized skills for clinical pharmacists*b 4.368 0.955 0.219 80.000 21.506 2.11 Whether interns are trained in core pharmacist competencies*b 4.316 0.671 0.155 72.353 22.229 2.12 Whether the lead teacher shows humanistic care for the interns in the process of teaching 4.526 0.697 0.154 80.000 21.213 3. Readiness of the internship model 4.368 0.761 0.174 3.1 Whether or not the lead instructor uses a diversified internship teaching model 4.316 0.671 0.155 74.118 22.377 3.2 Whether to rationally arrange the content of teaching according to the length of internship time 4.421 0.692 0.157 82.941 17.235 3.3 Whether the content of teaching is organized in accordance with the intern's practical needs and learning abilities 4.053 0.970 0.239 74.706 17.363 3.4 Whether interns have some freedom of time*a 3.421 1.071 0.313 71.176 19.327 3.5 Whether it is a combination of theoretical and practical model of teaching and learning 4.579 0.507 0.111 84.118 14.168 4. Readiness to assess the effectiveness of internships 4.263 0.806 0.189 4.1 Whether interns are consulted to assess each individual's internship needs 3.684 1.057 0.287 70.000 20.917 4.2 Whether the learning environment is assessed to meet the needs of the interns 3.526 0.905 0.257 68.824 16.539 4.3 Whether or not the intern is assessed on whether the content of the internship meets the needs of the internship 4.000 0.816 0.204 74.118 16.977 4.4 Whether interns are assessed to have the appropriate basic knowledge before joining the department 3.842 1.119 0.291 64.118 21.523 4.5 Whether there is a regular or periodic evaluation of the internship process*b 4.158 0.765 0.184 72.941 12.127 4.6 Whether the assessment of interns includes theoretical examinations and clinical practice tests 4.474 0.513 0.115 77.647 19.852 4.7 Whether there is an evaluation of the effectiveness of the supervisor's supervision by the internship supervision team 4.158 0.765 0.184 69.412 25.365 4.8 Availability of interns' assessment of the effectiveness of the lead teacher's guidance 4.368 0.761 0.174 71.176 21.472 5. Preparedness for Emergency Management for Internship Leaders 3.947 1.079 0.273 5.1 Whether to establish contact information for interns and lead teachers 4.368 0.684 0.157 93.529 10.572 5.2 Availability of two-way feedback channels for problems in the teaching-learning process 4.579 0.607 0.133 88.824 14.090 5.3 Availability of emergency plans for personal safety and health safety 4.579 0.692 0.151 84.118 15.835 5.4 Whether to educate interns on occupational safety and promote self-protection awareness 4.526 0.697 0.154 90.000 13.229 *a denotes indicator deletion; *b denotes indicator language change;SD denotes standard deviation;CV denotes coefficient of variation In QR2, experts were asked to rate the current level of preparedness of China's internship teaching in terms of each indicator on a scale from 0 to 100. The mean values of readiness for each indicator ranged from 61.118 (± 21.523)/100 (whether interns were assessed to have the appropriate basic knowledge before joining the department) to 93.529 (± 10.572)/100 (whether contact information between interns and teaching faculty was established). Among them, the readiness for emergency management of internship teaching was the highest, with an average of 89.118; the readiness for organizational structure of internship teaching (average: 81.25) and the readiness for internship teaching content (average: 81.226) were rated higher; The scores for the internship teaching model (average: 77.412) and the readiness for evaluation of internship teaching effects (average: 71.03) were low. Figure 3 shows the correlation between the importance scores and readiness for each indicator of the self-assessment tool for internship teaching in the pharmacy departments of healthcare organizations (r = 0.722, p < 0.0001). DISCUSSION In this study, the experts who participated in the Delphi correspondence were from seven hospitals and two universities in four different provinces and cities in China. In addition, the consulting experts were teachers engaged in teaching and experienced hospital instructors, and the expert authority coefficient was 0.779, which ensured the objectivity and robustness of the results. The Kendall consistency coefficient of the two rounds of correspondence was statistically significant, proving that the constructed self-assessment tool for internship teaching in pharmacy departments of healthcare organizations is reliable. However, experts' ratings of readiness for various aspects of internship teaching varied, indicating that our healthcare organizations need improvement in two areas: the internship teaching model and the assessment of the effectiveness of internship teaching. The results of this study show that the organizational structure of internship teaching includes the infrastructure and hardware of the internship teaching department, systems related to internship teaching, and the selection and training of teachers. The pharmacy department of a healthcare institution should be well prepared in terms of organizational structure concerning these aspects, providing a sound infrastructure and system for teaching internships, as well as selection criteria and training for teachers. In terms of the organizational structure of internship teaching, the ratings were low for “Availability of job descriptions for lead teachers” and “Whether the lead teacher receives regular training in relevant teaching and pharmacy service training”. Our pharmacy graduates lack a clinical rotation training system for residents, legal safeguards and guidelines for action, qualified clinical practice lead teachers, and accredited internship sites [25] . In Japan [26] , the government has established accreditation standards for internship sites to guarantee effective internships: basic hardware facilities, standardized teacher qualification requirements, and defined training guidelines and assessment programs. In Korea [27-29] , universities and hospital pharmacies have cooperated to establish and improve a set of education and assessment models - the hospital pharmacy department and the school pharmacy program work closely together, the hospital pharmacy department is mainly on the students' internship management, and the school supports the hospital pharmacy department, both sides collaborate, and develop together. At present, some large hospitals and large pharmacy chains in China have set up internship bases with schools to receive a large number of interns majoring in pharmacy from higher vocational colleges and universities; However, there is no unified certification standard for the construction of internship bases, and there are no detailed requirements for the hardware of the internship conditions and the experience of the supervising teachers, which makes it difficult to guarantee the effect of internship [30] . there is no unified standard for the selection and training of internship instructors in China, and instructors lack assessment indicators and incentives [31] . Based on the above analysis, in the future, we need to strengthen the position awareness of the teachers in the ideology; at the ability level, we need to improve the comprehensive ability and level of the teachers; at the system level, we need to improve the access system of the teachers, the evaluation mechanism of the effect of teaching and the construction of the guarantee mechanism. At the institutional level, it is necessary to improve the access system, the evaluation mechanism of the teaching effect, and the construction of the guarantee mechanism [32] . According to the results of this study, the content of internship teaching includes professional orientation and ethics training, pre-service training, training in the dispensing department, and practical training in the clinical department. Regarding the teaching content of internship teaching, the interns were rated low in terms of professional orientation and ethics training and pharmacist core competency training as well as the learning of pharmacy information technology operating system. Internship is a critical period for most graduates' career decision-making, and graduation internship is an important way for students to fully understand the content of the work and the current situation of employment, so that they can better choose employment and further education reasonably according to their actual situation, In addition, internship can provide better preparation for future clinical work. Therefore, during the internship period, we should enhance the interns' awareness of the pharmacy profession and their career planning for the future [33, 34] . The core competencies of hospital pharmacists refer to the knowledge, skills, judgment, and personal attributes required for pharmacists to provide safe, effective, cost-effective, and ethical patient-centered pharmacy services, including professional practice, coordination and communication, management, professional development, and critical thinking [35-37] . Training interns in core pharmacist competencies can enhance pharmacy services. China's hospital pharmacy services are gradually changing from purely "drug-centered" to "patient-centered" [38] . The development of "patient-centered" pharmacy service is still facing the change of service concept, the lack of patients' awareness of pharmacy service, the business level of pharmacy personnel needs to be improved, the establishment of clinical pharmacists, and other issues. Therefore, there is an urgent need for relevant regulations and policies to clearly define the contents of the work and guide the hospital pharmacy services to be perfected towards systematization, standardization, and rationalization [39] . The research results show that internship teaching modes include diversified teaching modes, theory and practice teaching modes, and arranging teaching contents according to the length of internship and different levels of interns. In terms of the teaching mode, the ratings of whether to adopt diversified teaching modes and whether to arrange the teaching contents according to the interns' needs and learning abilities were low. The traditional internship teaching mode is mostly led by the teacher, and the interns are in a passive acceptance state, which weakens the students' motivation to learn and reduces the interns' initiative [40] . New teaching methods such as Problem-Based Learning (PBL) [41] and Case Based Learning (CBL) can help improve the effectiveness of internships [42] . The use of diversified teaching methods stimulates students' motivation and enhances their independent learning and research abilities, giving them good clinical and communication skills, thus improving the effectiveness of the internship [43] .The level of interns in China's pharmacy program varies, and teachers should rationally arrange the content of teaching according to the interns' needs and learning abilities. The results of this study show that the assessment of the effectiveness of internship teaching should include access assessment, process assessment, outcome assessment, and bidirectional assessment; however, the overall scores in the aspect of the assessment of the effectiveness of internship teaching in China are low, indicating that there is a difference between China's internship teaching system and that of the developed countries in these aspects:(1) Lack of access assessment. Because of the late start of pharmacy internship teaching in China, the pharmacy departments of medical institutions accept interns at different levels of specialties, undergraduate and master's degrees, and there is a lack of criteria for access assessment of interns. In Japan, students are required to pass the Pharmacy Common Achievement Test (CBT: Computer-Based Testing and OSCE: Objective Structured Clinical Examination) before participating in pharmacy internships, which prevents students without pharmacist licenses from participating in training site pharmacy internships [26, 44] . In the United States, a pharmacist can only become a clinical pharmacist after obtaining a doctor of pharmacy degree, passing the national standardized examination, and then undergoing 1-2 years of residency pharmacist training [45] . (2) Defects in process evaluation and result evaluation. China's pharmacy graduates are generally poor in practical ability, the reason is that the practice education system is not perfect, the domestic teaching hospitals mostly use the traditional written and operational examinations, and there is a lack of perfect assessment and evaluation system when assessing the results of internship [6] . Foreign pharmacy internships need to participate in several practical courses, and throughout the entire period of professional learning, the assessment includes daily attendance, network testing, meetings and discussion performance, mentors and classmates evaluation, and other forms of assessment, each part of the results multiplied by the weighting of the final results [46] . (3) Look forward to establishing a two-way assessment scheme. Two-way assessment includes the evaluation of the teaching staff and the interns, and the evaluation of the teaching staff is mainly from the interns and the teaching team to make a comprehensive evaluation of the teaching attitude, teaching content, and teaching effect of the teaching staff. Strengths and limitations The strengths of this paper are mainly in the following aspects: 1) This study used a mixed-methods approach, which allowed the indicators of the assessment tool to be derived primarily from the first-hand experiences of interns and lead teachers, enhancing the validity of the tool. 2) The experts participating in this study are from the pharmacy departments of several large comprehensive medical institutions across the country, which guarantees the representativeness and rigor of the study. Of course, several limitations are worth mentioning. First, the self-assessment tool for internship teaching readiness is a dynamic system that will change with the development of hospital pharmacy and the national healthcare reform, and It still needs to be improved and the relevant indexes to make the self-assessment tool more specific and practical in practice. Secondly, this study has not conducted a large-scale empirical study on the self-assessment tool; the next step will be to continue to conduct empirical studies nationwide to test the reliability and operability of the self-assessment tool, and to further improve the index system so that it will be more valuable for application. Conclusion This is the first self-assessment tool for internship teaching proposed in China, which can provide a self-examination checklist and improve the level of internship teaching for pharmacy departments in medical institutions. Our study suggests that medical institutions should build a perfect pharmacy internship teaching program from the following aspects: 1. the organizational structure of internship teaching, the internship teaching department should provide perfect infrastructure and hardware, and there should be a system related to internship teaching as well as a program for the selection and training of teachers; 2. the content of the internship teaching should include professional orientation and ethics training, pre-service training, training in the transfer department and practical training in the clinical department; 3. In terms of the mode of internship teaching, there should be diversified modes of internship teaching, and the content of teaching should be reasonably arranged according to the length of internship and interns at different levels; 4. In terms of the evaluation of the effect of internship teaching, there are standards for access evaluation, process evaluation, result evaluation, and two-way evaluation; 5. In terms of the emergency management of internship teaching, there are plans for emergency management and a two-way feedback channel. Declarations Acknowledgements The authors acknowledge the support of all the interviewees and Correspondence experts who participated in the study Authors’ contributions Zhao Yin designed the study; Zhao Yin and Xuedong Jia conducted the interviews; Huitao Huang and Zhao Yin analyzed the data, Huitao Huang wrote the manuscript. Zhao Yin was particularly involved in the drafting, and revising of the different versions of the manuscript, and final approval of the version to be published. All authors contributed to the study's conception and design, All authors read and approved the final manuscript. Funding The work was supported by Henan Medical Education Research Project (WJLX2023016) 、 Henan Provincial Medical Science and Technology Public Welfare Program Soft Science Project,( RKX202302017) and Henan Zhongyuan Medical Science and Technology Innovation Development Foundation(ZYYC202301YB) Availability of data and materials The datasets used and/or analyzed during the current study are available from the Co-first author on reasonable request. Declarations Ethics approval and consent to participate Ethics was approved by The First Affiliated Hospital of Zhengzhou University The Institutional Review Board approved the protocol (2019-KY-304). Written informed consent was obtained from all the study participants. The study was conducted by the Declaration of Helsinki. Consent for publication Not applicable. Competing interests All authors declare no competing interests. References GIMENO-JORDA M J, GIMENEZ-PODEROS T, NEGRO-VEGA E, et al. 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10:16:56","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4222246/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4222246/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12909-024-06088-5","type":"published","date":"2024-10-11T15:57:08+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":54702618,"identity":"ace1ce84-d367-454e-afe7-17f8500cd87e","added_by":"auto","created_at":"2024-04-15 12:43:44","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":204122,"visible":true,"origin":"","legend":"\u003cp\u003eResearch methodology\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-4222246/v1/0b8383459571c9bffb6ad154.png"},{"id":54702619,"identity":"fd232425-e433-438d-b090-92a166149bb7","added_by":"auto","created_at":"2024-04-15 12:43:44","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":128470,"visible":true,"origin":"","legend":"\u003cp\u003eResults of the qualitative study\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-4222246/v1/4b336fabaa658f1ba9c18912.png"},{"id":54702623,"identity":"0c15e9f2-f57b-4ece-a33e-5a00af85bac8","added_by":"auto","created_at":"2024-04-15 12:43:44","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":27658,"visible":true,"origin":"","legend":"\u003cp\u003eCorrelation chart between importance score and readiness score\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-4222246/v1/f7c4c2cb77eef377c2ae2d5c.png"},{"id":66597432,"identity":"1e123900-ad9a-4c6a-9eae-2c430d271159","added_by":"auto","created_at":"2024-10-14 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12:43:44","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":16231,"visible":true,"origin":"","legend":"","description":"","filename":"Appendix2.docx","url":"https://assets-eu.researchsquare.com/files/rs-4222246/v1/9a120800dec6307f39416c45.docx"},{"id":54702622,"identity":"fd81c453-e41d-4879-8dc7-c98e09599f0d","added_by":"auto","created_at":"2024-04-15 12:43:44","extension":"docx","order_by":3,"title":"","display":"","copyAsset":false,"role":"supplement","size":36496,"visible":true,"origin":"","legend":"","description":"","filename":"Appendix3.docx","url":"https://assets-eu.researchsquare.com/files/rs-4222246/v1/54558c2c499b6b717e33c2d8.docx"},{"id":54702624,"identity":"9b16b9fc-ec29-437c-b7e8-9d0c1c1a2608","added_by":"auto","created_at":"2024-04-15 12:43:44","extension":"docx","order_by":4,"title":"","display":"","copyAsset":false,"role":"supplement","size":27431,"visible":true,"origin":"","legend":"","description":"","filename":"Appendix4.docx","url":"https://assets-eu.researchsquare.com/files/rs-4222246/v1/c08a003a37a239cc5952c482.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Construction of a self-assessment tool for the readiness of pharmacy departments for internship teaching in public healthcare organizations-An Exploratory Mixed Study","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eInternships in medical institutions are crucial for pharmacy students. During this practical stage, students enhance their hands-on skills and apply theoretical knowledge to real-world tasks, such as dispensing medications and providing drug consultations. It serves as a pivotal period for students transitioning from pharmacy academics to the role of hospital pharmacists. Through practical experience, they gain a better understanding and adaptation to the requirements of pharmaceutical services in hospitals, preparing them for future involvement in comprehensive pharmaceutical care\u003csup\u003e[1]\u003c/sup\u003e. Moreover, medical institution internships offer comprehensive career preparation, fostering communication with patients and healthcare professionals, as well as cultivating teamwork and other essential competencies. Accumulating internship experience allows students to delve deeper into the operational aspects of medical institutions and the needs of patients, laying a solid foundation for delivering personalized pharmaceutical services\u003csup\u003e[2]\u003c/sup\u003e. In summary, internships in medical institutions provide valuable hands-on opportunities for pharmacy students, establishing a critical foundation for their future professional development. Public medical institutions serve as the primary venues for pharmacy student internships, undertaking significant teaching responsibilities for pharmaceutical interns\u003csup\u003e[3]\u003c/sup\u003e. Moreover, the internship programs, content, modes, and expertise of teaching staff in medical institutions significantly impact the effectiveness and satisfaction of internships. Currently, there is a lack of precise self-assessment tools in China for evaluating the preparedness of pharmaceutical departments in medical institutions for internships, highlighting the need for attention to this issue. Therefore, establishing appropriate self-assessment tools is crucial for enhancing internship quality and satisfaction.\u003c/p\u003e\n\u003cp\u003eEvaluating the readiness of internship mentoring in pharmaceutical departments of medical institutions has been a focal point in international research. Key assessment factors encompass mentor qualifications, teaching resources, the practicality of internship courses, comprehensive internship arrangements, effective evaluation tools, and feedback mechanisms, and fostering collaborative relationships. Through methods such as surveys, interviews, observations, and communication with interns, ensuring that medical institutions provide high-quality and comprehensive training experiences is crucial for enhancing interns\u0026apos; capabilities and professional competence. Zhao et al.\u003csup\u003e[4]\u003c/sup\u003e reported tools for assessing interns\u0026apos; training experiences, such as the \u0026quot;Postgraduate Hospital Educational Environment Measure (PHEEM), Perceived Stress Scale (PSS), General Health Questionnaire-12 or 30 (GHQ-12 or GHQ-30), Patient Health Questionnaire-9 (PHQ-9), and Maslach Burnout Inventory (MBI).\u0026quot; PHEEM consists of three subscales: role autonomy, teaching, and social support, with 40 questions addressing specific aspects of the educational environment. Despite extensive international research on internship mentoring experiences, including qualitative studies, surveys of interns, and evaluation tools, a universally accepted assessment tool is still lacking. Similarly, domestic scholars in China have explored the hospital pharmacy internship mentoring model, discussed challenges and solutions, and summarized mentoring teachers\u0026apos; experiences\u003csup\u003e[5-9]\u003c/sup\u003e. Currently, there is a gap in evaluating the readiness of pharmaceutical departments in Chinese medical institutions for internship mentoring.\u003c/p\u003e\n\u003cp\u003eCompared to the over 60-year development of hospital pharmacy education in the United States, China initiated pharmacy internship mentoring relatively late, initially focusing on training programs. From 1980 to 1982, institutions such as Shanghai Medical University (now part of Fudan University School of Medicine), China Pharmaceutical University, and West China Medical University organized clinical pharmacy training courses to cultivate key personnel in clinical pharmacy. In 1993, the Ministry of Health established a Clinical Pharmacy Training Center at the School of Pharmacy at Shanghai Medical University to train clinical pharmacy professionals nationwide. In November 2005, the Ministry of Health issued notices and plans to pilot clinical pharmacist training programs, outlining the purposes, goals, content, funding, timing, and management of the training initiatives, exploring models for clinical pharmacist development, and related policies\u003csup\u003e[10, 11]\u003c/sup\u003e. In recent years, with the rapid development of China\u0026apos;s hospital pharmacy sector, relatively mature internship mentoring systems have gradually formed in some large comprehensive tertiary hospitals\u003csup\u003e[12]\u003c/sup\u003e. In Beijing, the clinical practice and standardized training for hospital pharmacists after graduation are divided into two stages. The first stage, known as the general pharmacist training phase, covers six key skills: prescription review and dispensing, drug dispensing, medication consultation, adverse reaction reporting, pharmacy management, and drug quality management. The second stage, the clinical pharmacist training phase, focuses on six skills: ward rounds, consultations, discussions on challenging cases, information intelligence, patient education, and medication history documentation. The PLA General Hospital categorizes trainees into seven levels: clinical pharmacist instructor trainees, clinical pharmacist trainees, hospital pharmacist trainees, pharmacy graduate students, pharmacy undergraduate students, pharmacy continuing education students, and pharmacy professionals. Targeted common and personalized training goals are established, ensuring that individuals across categories master basic pharmacological effects, adverse reactions, and the hospital pharmacy workflow, While observing the current methods and content of pharmacy internship mentoring in China, several issues persist. These include the lack of national operational guidelines, the absence of systematic internship mentoring plans, a shortage of authoritative evaluation tools for internship effectiveness, and inconsistent training programs among various medical institutions\u003csup\u003e[13]\u003c/sup\u003e. Additionally, the approach to interns differs from that in foreign countries, where interns are mainly recruited with certain admission standards, receive paid internships, and have a more structured hierarchy. In contrast, Chinese medical institutions\u0026apos; pharmacy departments accept interns from different educational levels, including diploma, bachelor\u0026apos;s, and master\u0026apos;s degrees, leading to distinct challenges in internship mentoring. Therefore, developing a self-assessment tool for the readiness of pharmaceutical departments in Chinese medical institutions for internship mentoring holds significant importance in addressing the unique circumstances of the country.\u003c/p\u003e\n\u003cp\u003eBefore this, we used qualitative research methods to understand the experience and suggestions of both supply and demand on pharmaceutical practice in medical institutions from the perspective of interns and teachers. The interns who participated in the study mentioned the negative experiences of the internship process and reflected that there are still imperfections in the current pharmacy internship in China, such as insufficient clinical faculty ability, unreasonable internship mode, and unscientific internship content\u003csup\u003e[13]\u003c/sup\u003e. Similarly, the teacher also pointed out the problems existing in the practice teaching in our country, such as the lack of systematic practice teaching program; The content and mode of practice teaching lack of uniform standards; Lack of assessment of intern\u0026apos;s clinical practice ability; There is also a lack of scientific and effective evaluation tools\u003csup\u003e[14]\u003c/sup\u003e. Therefore, based on the previous research, this study intends to carry out exploratory mixed-method research from the perspective of the supply side and combined with China\u0026apos;s national conditions. The advantage of this approach is that it combines the advantages of qualitative and quantitative research, but also compensates for the shortcomings of each other\u003csup\u003e[15]\u003c/sup\u003e. The following research objectives are to be achieved: 1) to construct a self-evaluation tool for practice teaching readiness of pharmaceutical departments in medical institutions. 2) preliminary evaluation of the preparation of practice teaching in pharmaceutical departments of medical institutions.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cp\u003eEthical approvals\u003c/p\u003e\n\u003cp\u003eEthics was approved by The First Affiliated Hospital of Zhengzhou University Institutional Review Board approved the protocol (2019-KY-304). Written informed consent was obtained from all the study participants.\u003c/p\u003e\n\u003cp\u003eStudy Design\u003c/p\u003e\n\u003cp\u003eIn this paper, an exploratory mixed method was adopted for research\u003csup\u003e[16]\u003c/sup\u003e. In the first stage, an indicator pool was formed based on semi-structured interviews, and the first draft of the self-assessment tool for internship and teaching readiness of pharmaceutical departments in medical institutions was compiled based on the results of the literature review. The second stage: the Delphi method was used to select evaluation indexes, and the self-assessment tool of internship teaching readiness in the pharmacy department was constructed and optimized. We reported the entire mixed-methods study according to the Good Reporting of a Mixed Methods Study (See Appendix 1), the research ideas of this paper are shown in Figure 1.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePhase\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eI\u003c/strong\u003e\u003cstrong\u003e: qualitative study\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eParticipants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe inclusion criteria for interns are: 1. Willing to participate in this study 2. Internship in the hospital for at least three months 3. Completion of at least three years of study in the School of Pharmacy.\u003c/p\u003e\n\u003cp\u003eThe selection criteria for teaching teachers are: 1. Willing to participate in this study 2. Have rich work experience, intermediate title or above 3. Have teaching experience as an intern.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Collection\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFocus group interviews were conducted with interns from three large top three teaching hospitals in Henan Province (the first affiliated Hospital of Zhengzhou University, the third affiliated Hospital of Zhengzhou University, and the People\u0026apos;s Hospital of Henan Province) from February 2021 to June 2021. From three large-scale top three general hospitals in China (The First Affiliated Hospital of Zhengzhou University - Henan Province. Zhengzhou; the First Affiliated Hospital of Sun Yat-sen University - Guangdong Province. Guangzhou; Sichuan Provincial People\u0026apos;s Hospital - Sichuan Province. Chengdu) conducted a series of interview studies from January 2022 to March 2022. Before the beginning, the researchers introduced the background and purpose of the study to the selected tutors and interns. After obtaining the informed consent of the participants, the interview was conducted by one researcher and recorded by another researcher. The whole process was recorded. Data saturation was defined as \u0026ldquo;no new themes or codes emerging from interviews\u0026rdquo;. Finally, 16 interns and 14 teachers participated in this qualitative study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInterview data were analyzed using thematic analysis, a method widely used in qualitative research to identify, analyze, and report data patterns. Key steps in the topic analysis include familiarity with data, generating initial code, searching and reviewing topics, naming topics, and generating final reports, The researchers transcribed the recordings within 24 hours, using NVivo12 to manage and analyze the data. The two researchers independently extracted the code and wrote the first draft of the topic and subtopics. Subsequently, the research group discussed the first draft of the theme and sub-theme, and put forward opinions and suggestions on the topic structure and language expression, and the final theme and sub-theme were formulated with the consent of the research group, and the appropriate representative citations were selected to present the theme or sub-theme. The qualitative report follows the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist (see Appendix 2).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePhase\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eII\u003c/strong\u003e\u003cstrong\u003e: qualitative study\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe Delphi method\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Delphi method is a widely used methodological tool for building group consensus, where consensus is reached through multiple rounds of questionnaires providing group opinions with individual feedback. Experts fill out the questionnaires anonymously without discussing them with each other, which has a certain degree of subjectivity, so the selection of representative experts is the key to the implementation of the Delphi method, which determines the authority, scientificity, and validity of the findings of the study.\u003csup\u003e[17, 18]\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEstablishing of the expert panel\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Delphi method generally requires the selection of experts to be authoritative and representative professionals in the relevant fields, and the number of 15 to 50 is preferable.\u003csup\u003e[19]\u003c/sup\u003e\u0026nbsp; The selection criteria for this study were: (1) tertiary hospitals with more than 5 years of experience in the specialized field of hospital pharmacy; (2) willingness to cooperate in completing multiple rounds of expert correspondence.\u003c/p\u003e\n\u003cp\u003eOn the basis of a comprehensive analysis of qualitative research results and literature review, the group discussed and finalized the first draft of the expert correspondence form containing 5 primary indicators and 37 secondary indicators. The first draft of the expert correspondence form was finalized after discussion by the group\u003csup\u003e[20]\u003c/sup\u003e. The first draft of the expert consultation questionnaire consists of three parts, the first part is the general information about the experts: age, years of experience, education, title, etc.; the second part is the self-assessment tool for self-assessment of the readiness of the pharmacy department of the health care institution to teach internships Indicator Importance Evaluation Scale, which evaluates the importance of the indicators using a Likert five-point scale, with 5=very important, 4=important, 3=generally important, 2=unimportant, and 1=not important at all, and provide a suggestion column; Part III Indicator Judgment Basis Table: expert scores for familiarity with survey content and indicator judgment\u003csup\u003e[21]\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eIn this paper, two rounds of expert correspondence were conducted in strict accordance with the Delphi method, with pre-surveys before the correspondence, and timely modification and improvement of problems to ensure the validity of the questionnaire and its operability. Cognitive interviews were conducted with two experienced teachers from the pharmacy departments of healthcare organizations before each correspondence. In the presence of the research team, the teachers read out the questions aloud stated their own understanding, and selected the options they thought were appropriate, in order to gain a deeper understanding of the problems in the questionnaire and make timely modifications and improvements, so that the results of the survey would be more reliable\u003csup\u003e[22]\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eIn June-August 2023, the online survey was implemented using the online platform Questionnaire Star (Changsha Ranxing Information Technology Co., Ltd), a widely used free online questionnaire platform in China. Firstly, we introduced the study background to the experts and obtained informed consent, the experts rated the indicators and suggested modifications. We collated and summarized the experts\u0026apos; opinions, designed a second round of questionnaires, and consulted the experts again on whether they agreed to delete the indicators with significance means \u0026lt;4.0 and coefficients of variation \u0026gt;0.25, and asked the experts to rate the current organizational structure of the pharmacy departments of medical institutions in China in terms of the organizational structure of internship tutoring, the content of internship tutoring, the mode of internship tutoring, assessment of internship tutoring effects, and emergency management of internship tutoring\u003csup\u003e[23]\u003c/sup\u003e. both questionnaires were provided as supplementary materials (Appendices 3 and 4).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAnalysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eExcel and SPSS software were used to process the results of the questionnaire and statistically analyze the arithmetic mean, standard deviation, coefficient of variation, and Kendall\u0026apos;s coordination coefficient of the importance of each indicator. The questionnaire recovery rate represents the positive degree of experts; the coefficient of expert authority (Cr) is the average of the expert\u0026apos;s familiarity with the indicators (Cs) and the coefficient of indicator judgment (Ca)\u003csup\u003e[24]\u003c/sup\u003e; the degree of harmonization of experts\u0026apos; opinions is represented by the coefficient of variation and Kendall\u0026apos;s harmonization coefficient.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cp\u003e\u003cstrong\u003eDemographic Characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe first phase of the qualitative study involved 16 interns and 14 teachers. The average age of the 16 interns was 21 years old, and the duration of the internship was more than 6 months, their demographics are shown in Table 1. The average age of the 14 teachers was 36.1 years and the average length of service was 11.3 years, their demographic data are shown in Table 2.\u003c/p\u003e\n\u003cp\u003eTable 1:Demographic Characteristics of 16 interns\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"61.09154929577465%\" valign=\"top\"\u003e\n \u003cp\u003eCharacteristics\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.90845070422535%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;Value\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"61.09154929577465%\" valign=\"top\"\u003e\n \u003cp\u003eGender,n\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;Male\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;Female\u003c/p\u003e\n \u003cp\u003eAge, years\u003c/p\u003e\n \u003cp\u003eMean (range)\u003c/p\u003e\n \u003cp\u003eMedian\u003c/p\u003e\n \u003cp\u003eMajor\u003c/p\u003e\n \u003cp\u003eNumber of departments rotated, n\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;1department\u003c/p\u003e\n \u003cp\u003e2-3 department\u003c/p\u003e\n \u003cp\u003e4-6 department\u003c/p\u003e\n \u003cp\u003eIntership duration, n\u003c/p\u003e\n \u003cp\u003e6 months\u003c/p\u003e\n \u003cp\u003e7 months\u003c/p\u003e\n \u003cp\u003e8 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.90845070422535%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e21(20-24)\u003c/p\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003cp\u003ePharmacy\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eTable 2:Demographic Characteristics of 14 teachers\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"61.09154929577465%\" valign=\"top\"\u003e\n \u003cp\u003eCharacteristics\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.90845070422535%\" valign=\"top\"\u003e\n \u003cp\u003eMean (SD) or n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"61.09154929577465%\" valign=\"top\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;Male\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;Female\u003c/p\u003e\n \u003cp\u003eAge, mean\u0026nbsp;（SD）\u003c/p\u003e\n \u003cp\u003eWorking years, mean(SD)\u003c/p\u003e\n \u003cp\u003eTitle\u003c/p\u003e\n \u003cp\u003eIntermediate level\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eAssociate Advanced level\u003c/p\u003e\n \u003cp\u003eAdvanced level\u003c/p\u003e\n \u003cp\u003eNumber of interns taught（number）\u003c/p\u003e\n \u003cp\u003e1-4\u003c/p\u003e\n \u003cp\u003e5-10\u003c/p\u003e\n \u003cp\u003e\u0026gt;10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38.90845070422535%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e6（42.86）\u003c/p\u003e\n \u003cp\u003e8（57.14）\u003c/p\u003e\n \u003cp\u003e36.1（6.2）\u003c/p\u003e\n \u003cp\u003e11.3（7.44）\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e9（52.63）\u003c/p\u003e\n \u003cp\u003e7（42.11）\u003c/p\u003e\n \u003cp\u003e1（5.26）\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e3（21.43）\u003c/p\u003e\n \u003cp\u003e8（57.14）\u003c/p\u003e\n \u003cp\u003e3（21.43）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eIn the second phase of the quantitative study, 19 of the 21 invited experts responded to the questionnaire in the first round of the Delphi correspondence. In the second round of the Delphi Correspondence, 17 of the 19 invited experts answered the questionnaire. The basic information of the experts interviewed by the two letters is shown in Table 3.\u003c/p\u003e\n\u003cp\u003eTable 3:Demographic Characteristics of the experts who participated in the two rounds of correspondence\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\" width=\"532\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.54887218045113%\" valign=\"top\"\u003e\n \u003cp\u003eCharacteristics\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.887218045112782%\" valign=\"top\"\u003e\n \u003cp\u003eQR1 \u0026nbsp; n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.56390977443609%\" valign=\"top\"\u003e\n \u003cp\u003eQR2 \u0026nbsp;n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.54887218045113%\" valign=\"top\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;Male\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;Female\u003c/p\u003e\n \u003cp\u003eAge(years)\u003c/p\u003e\n \u003cp\u003e\u0026lt;40\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e40-50\u003c/p\u003e\n \u003cp\u003e\u0026gt;50\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eWork experience in pharmacy (years)\u003c/p\u003e\n \u003cp\u003e4\u0026ndash;9\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;10\u0026ndash;19\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;20\u0026ndash;29\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;30\u0026ndash;39\u003c/p\u003e\n \u003cp\u003eTitle\u003c/p\u003e\n \u003cp\u003eIntermediate level\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eAssociate Advanced level\u003c/p\u003e\n \u003cp\u003eAdvanced level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.887218045112782%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e8（42.11）\u003c/p\u003e\n \u003cp\u003e11（57.89）\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e13（68.42）\u003c/p\u003e\n \u003cp\u003e5（26.32）\u003c/p\u003e\n \u003cp\u003e1（5.26）\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e10（52.63）\u003c/p\u003e\n \u003cp\u003e7（36.85）\u003c/p\u003e\n \u003cp\u003e1（5.26）\u003c/p\u003e\n \u003cp\u003e1（5.26）\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e10（52.63）\u003c/p\u003e\n \u003cp\u003e8（42.11）\u003c/p\u003e\n \u003cp\u003e1（5.26）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.56390977443609%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e7（42.11）\u003c/p\u003e\n \u003cp\u003e10（57.89）\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e12（68.42）\u003c/p\u003e\n \u003cp\u003e4（26.32）\u003c/p\u003e\n \u003cp\u003e1（5.26）\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e9（52.63）\u003c/p\u003e\n \u003cp\u003e6（36.85）\u003c/p\u003e\n \u003cp\u003e1（5.26）\u003c/p\u003e\n \u003cp\u003e1（5.26）\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e9（52.63）\u003c/p\u003e\n \u003cp\u003e7（42.11）\u003c/p\u003e\n \u003cp\u003e1（5.26）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eQualitative Results\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe qualitative research in the first stage finally extracted 5 primary themes and 22 sub-themes, as shown in Figure 2. The five first-level themes are the organizational structure of practice teaching, the content of practice teaching, the mode of practice teaching, the evaluation of practice teaching effect, and emergency management of practice teaching. Results of the qualitative study for themes, sub-themes, and representative quotations are in Table 4. Code G1P1-G2P3, P1-P7 for the teacher, G3P1-G5P5 for the intern.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4: Results of the qualitative study for themes, sub-themes, and representative quotations\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"757\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.3223249669749%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.17305151915456%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCode\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"74.50462351387054%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDescription\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.3223249669749%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eOrganizational structure of internship\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.17305151915456%\" valign=\"top\"\u003e\n \u003cp\u003eHardware and facilities for internship\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"74.50462351387054%\" valign=\"top\"\u003e\n \u003cp\u003e(G5P3) There are just too many people there, there\u0026apos;s limited space in the lab, and the students who go there can\u0026apos;t possibly say that if you\u0026apos;re interested, you can go to that kind of thing.... (G5P2) The mass spectrometer we have there are just so many students sitting there... I couldn\u0026apos;t even get into the room... Later, when that student came to me, there was no room for us to sit...\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.73198847262248%\" valign=\"top\"\u003e\n \u003cp\u003eDetailed internship syllabus or manual\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"81.26801152737752%\" valign=\"top\"\u003e\n \u003cp\u003e(G1P1) Then according to different specialties, there are different requirements, that is, for what you need to master the theoretical knowledge, what kind of clinical practice skills are a target requirement. So we have a basic syllabus to teach.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.73198847262248%\" valign=\"top\"\u003e\n \u003cp\u003eInternship management rules and regulations\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"81.26801152737752%\" valign=\"top\"\u003e\n \u003cp\u003e(G2P1) ... It will also include organizational management, which is training in day-to-day work management. That is, when you go to work when you go off work, and then when you should obey the substitute teacher. And then there will be such a training, and then there is also leave, this is more critical, can not move leave, leave of absence of a management system training\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.73198847262248%\" valign=\"top\"\u003e\n \u003cp\u003eIndividualized teaching programs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"81.26801152737752%\" valign=\"top\"\u003e\n \u003cp\u003e(P5) I think it is important to first of all, according to the intern\u0026apos;s position, that is, he may be a specialist, and the undergraduate of his foundation is not the same, he needs to master this is not particularly the same.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.3223249669749%\" rowspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003eInternship teaching content\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.17305151915456%\" valign=\"top\"\u003e\n \u003cp\u003ePre-job training (induction training)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"74.50462351387054%\" valign=\"top\"\u003e\n \u003cp\u003e(G2P2) When the students come over, I will do a half-hour to one-hour induction training. The main content is the distribution of our hospital, which is the basic information of the hospital, and then the basic information of the pharmacy department, because our pharmacy department may have more than ten departments in its management structure. The students may not be able to understand it, and then I will give them basic training.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.73198847262248%\" valign=\"top\"\u003e\n \u003cp\u003eDetailed internship syllabus or manual\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"81.26801152737752%\" valign=\"top\"\u003e\n \u003cp\u003e(P7) I would give them a detailed, this is the plan for the internship. It\u0026apos;s just generally specific to the point where it would be specific to the week, it\u0026apos;s every week, and roughly what\u0026apos;s going to be covered would be listed out for him.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.73198847262248%\" valign=\"top\"\u003e\n \u003cp\u003eContent and workflow of pharmacy work\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"81.26801152737752%\" valign=\"top\"\u003e\n \u003cp\u003e(G2P2) For us it would be required, for example, in emergency medicine, then you would have to teach at least two per month, interns. We said then the content of this course should be related to the day-to-day work of our emergency medicine transfers. And then this is some of the systems, and then the basic processes, and some of the job specifications.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.73198847262248%\" valign=\"top\"\u003e\n \u003cp\u003ePractical skills training\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"81.26801152737752%\" valign=\"top\"\u003e\n \u003cp\u003e(P5)Then, in the outpatient department, you have to tell the patient what precautions there are for this medicine... (P4) in addition, you can also give patients medication education...\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.73198847262248%\" valign=\"top\"\u003e\n \u003cp\u003eTraining in core competencies\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"81.26801152737752%\" valign=\"top\"\u003e\n \u003cp\u003e(G1P1) One of the main enhancement skills is the ability to review the literature and then organize it and summarise it...\u003cbr\u003e\u0026nbsp; (G1P3)... This communication skill of yours, actually I think it\u0026apos;s as important as the professional course...\u003cbr\u003e\u0026nbsp; (G5P2) I think that on the one hand, it\u0026apos;s developed my self-learning skills.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.73198847262248%\" valign=\"top\"\u003e\n \u003cp\u003eProfessional orientation and ethics training\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"81.26801152737752%\" valign=\"top\"\u003e\n \u003cp\u003e(P5) As an instructor, when you come into contact with the interns, you hope that they will make a lot of progress, or have a preliminary understanding of the direction of their future work... For example, the direction of pharmacists now is to have more contact with patients...\u003cbr\u003e\u0026nbsp; (G4P2): It may give us some direction, there may be more choices after graduation to see which one they are suitable for...\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.3223249669749%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eInternship and teaching mode\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.17305151915456%\" valign=\"top\"\u003e\n \u003cp\u003eIntern\u0026apos;s needs and learning abilities\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"74.50462351387054%\" valign=\"top\"\u003e\n \u003cp\u003e(G1P4) I think because frankly a variety of banding models, for an undergraduate intern, what kind of banding model does he need? I think it probably goes to the root of what kind of needs he has. Right? \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; (G5P3) It should still depend on the individual, we were here when Mr.Pao told us that although it was mainly a sub kind of thing, it still allows you to choose on your own, and then after you\u0026apos;ve chosen it, the teacher in then adjusts it according to the real situation of each department.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.73198847262248%\" valign=\"top\"\u003e\n \u003cp\u003eTeaching model combining theory and practice\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"81.26801152737752%\" valign=\"top\"\u003e\n \u003cp\u003e(G1P3) A model of practice leading... We focus very much on the practical aspect of it...\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.73198847262248%\" valign=\"top\"\u003e\n \u003cp\u003eLength of internship\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"81.26801152737752%\" valign=\"top\"\u003e\n \u003cp\u003e(P3). One problem is that lies in the fact that it\u0026apos;s because some of the students who come to study have a long time, some have a short time, and the question of the length of time, yes, the question of the length of time, actually has a big impact on this for us. Because if it\u0026apos;s a short time, even though this is the piece of him that I\u0026apos;ve trained him well, he\u0026apos;s going to switch subjects soon. And then for me, I spend a lot but the student actually can\u0026apos;t fully grasp what the teacher is teaching.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.73198847262248%\" valign=\"top\"\u003e\n \u003cp\u003eCertain degree of freedom in their time\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"81.26801152737752%\" valign=\"top\"\u003e\n \u003cp\u003e(P7)... Then after coming to us, that is, we have relatively large degrees of freedom then, he may not have, not yet adapted (G4P3).... People do want to specialize in this, learning is also quite good, specializing in this pressure is also quite big is special, just want to have a little more time to learn, you can negotiate it!\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.3223249669749%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003eEvaluation of the effectiveness of internship\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.17305151915456%\" valign=\"top\"\u003e\n \u003cp\u003eMeets the internship needs\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"74.50462351387054%\" valign=\"top\"\u003e\n \u003cp\u003e(P7)... We will display our research directions one by one, and then let the students look at them and introduce them, and then see if they are interested in the direction of their graduate studies or if they are interested in their \u0026nbsp;interests, and then we will let the teachers communicate with them after you have selected them. If you feel that they are a good match, then they will be assigned to the appropriate content of the subject group.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.73198847262248%\" valign=\"top\"\u003e\n \u003cp\u003eIEquipped with basic knowledge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"81.26801152737752%\" valign=\"top\"\u003e\n \u003cp\u003e(P1) There was a student from the Railway Institute of Vocational Technology, and when you asked him about antibiotics, cephalosporins, generation one, generation two, and generation three, he didn\u0026apos;t know, these are the most basic, the simplest, and he didn\u0026apos;t understand even when he asked him... Are you unable to teach him, how do you teach him... \u0026nbsp; \u0026nbsp; \u0026nbsp; (G3P2) I think my truest feeling is that my knowledge is too little. The knowledge base is too little. I feel like I don\u0026apos;t know anything since I\u0026apos;ve been here.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.73198847262248%\" valign=\"top\"\u003e\n \u003cp\u003eEvaluations of the internship process\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"81.26801152737752%\" valign=\"top\"\u003e\n \u003cp\u003e(G1P3) Process assessment vs. In fact, our question paper is only for the final examination, it is a stage examination... Yes, and then the process assessment is actually like the medication education guide that I just mentioned or the medical advice pharmacy consultation. This is because it will be carried out every day... Finally the process of stopping clinical practice, you\u0026apos;ll see that he\u0026apos;s crossed the line.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.73198847262248%\" valign=\"top\"\u003e\n \u003cp\u003eTwo-way assessment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"81.26801152737752%\" valign=\"top\"\u003e\n \u003cp\u003e(G2P1) We kinda accept that two-way assessment ..... The two-way, it includes the teacher\u0026apos;s consideration of the student, then our department\u0026apos;s consideration of the student, the hospital\u0026apos;s consideration of the student, and in turn, the student\u0026apos;s consideration of the instructor, the student\u0026apos;s consideration of the department in which he\u0026apos;s rotating. .... And then as well as the management of our department, he is in the pharmacy department, an evaluation of the pharmacy department, and even an evaluation of the entire management of the hospital.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.73198847262248%\" valign=\"top\"\u003e\n \u003cp\u003eTheoretical examinations and clinical practice\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"81.26801152737752%\" valign=\"top\"\u003e\n \u003cp\u003e(G1P1) And then there\u0026apos;s also the paper that\u0026apos;s specifically for interns... And then there\u0026apos;s a paper for interns to improve their theoretical knowledge and professional skills.\u003cbr\u003e\u0026nbsp; (G1P2) For clinical pharmacists, it\u0026apos;s generally theory, right? And then there\u0026apos;s also a skills test.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.3223249669749%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eTheoretical examinations and clinical practice\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.17305151915456%\" valign=\"top\"\u003e\n \u003cp\u003eContact information for each other\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"74.50462351387054%\" valign=\"top\"\u003e\n \u003cp\u003e(G1P1).... And also with his guidance counselor and the group leader, anyway, all the various students went to contact him, and he couldn\u0026apos;t be contacted at home, including his parents, because he switched off his phone .... Then it was very anxious, yes, it was very anxious.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.73198847262248%\" valign=\"top\"\u003e\n \u003cp\u003eEmergency plans for safety and health\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"81.26801152737752%\" valign=\"top\"\u003e\n \u003cp\u003e(G1P1) Then I asked their group leader, I said why this student didn\u0026apos;t come to class, and then the group leader said he didn\u0026apos;t know, and then later on he asked them to contact this student, and it turned out that no one could find him... That process was really too, too scary (P3) But I, if you have anything, anything, you have to take leave from me. Yeah, and then we\u0026apos;re still responsible for your safety here.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.73198847262248%\" valign=\"top\"\u003e\n \u003cp\u003eThere are two-way feedback channels\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"81.26801152737752%\" valign=\"top\"\u003e\n \u003cp\u003e(G2P3) During the training in the admission to the department, they will be told that if they have any problems in the course of their daily internship, they can first react to the departmental team leader, for example, Mr Ren, or Mr Yuan. If you think it\u0026apos;s not good to communicate, you can come back to me, I\u0026apos;ll deal with it, I\u0026apos;ll communicate, will give them that (P2)... We have to communicate promptly, that is, you have to it\u0026apos;s quite normal that the problem is not resolved. But when you communicate, I know what you have probably worked on, and what are your interests in this area.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eQuantitative Results\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn this study, the authority coefficient of experts is 0.779, close to 0.80, which indicates that the experts participating in this study have a high degree of authority, The Kendall coordination coefficient of the primary index was 0.216, P\u0026lt;0.001; the Kendall coordination coefficient of the secondary index was 0.172, P\u0026lt;0.001, and the evaluation results of the indicators by the experts have consistency, which have laid a good theoretical foundation for the quality and reliability of the construction of the indicator system.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eQuestionnaire round 1 (QR1)\u003c/p\u003e\n\u003cp\u003eIn the first round, four experts proposed amendments, one of whom suggested deleting \u0026quot;3.4 Whether interns have some freedom of time\u0026quot;. The other three experts proposed language changes to four indicators, suggesting that the first level indicator \u0026quot;the degree of preparation of content for teaching internships\u0026quot; be changed to \u0026quot;Preparedness of content for teaching internships\u0026quot;, and that the second level indicator \u0026quot;2.1 Whether interns are provided with training in vocational orientation and professional ethics in order to enhance interns\u0026apos; awareness of the specialty and their future career planning\u0026quot; be changed to \u0026quot;Whether interns are provided with vocational orientation and professional ethics training \u0026quot;. The indicator \u0026quot;2.2 Whether to provide interns with career orientation and professional ethics training to enhance their awareness of the specialty and their future career planning\u0026quot; was changed to \u0026quot;The content of the pre-service training is well developed, including an introduction to the relevant pharmacy rules and regulations of the hospital and the department, the management rules for interns, and an introduction to the departmental settings and functions of the department\u0026quot; .\u0026quot;4.5 Whether there is a dynamic assessment of the internship process should be changed to Whether there is a regular or periodic evaluation of the internship process\u0026quot;.One of the experts suggested that \u0026quot;some secondary indicators have the phenomenon of multiple questions in one entry, which is not in line with the basic principle of entry design\u0026quot;, and after discussion by the panel, it was decided to change \u0026quot;2.10 Whether there is a teaching internship for clinical pharmacists specializing in prescription review, formulation of pharmacy monitoring plan, clinical medication guidance, rational medication evaluation, etc.\u0026quot; to \u0026quot;2.10 Whether there are teaching internships of specialized skills for clinical pharmacists\u0026quot;; 2.11 Whether interns are trained in core competencies such as communication skills, clinical thinking skills, research thinking skills, independent learning skills, critical thinking, etc. was changed to 2.11 whether interns are trained in the core competencies of pharmacists\u0026quot;. The mean, standard deviation, and coefficient of variation of each indicator were calculated by scoring the importance of\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ethe indicator by experts. The mean value of the primary indicator \u0026quot;preparedness for emergency management of internship teaching\u0026quot; and five secondary indicators (1.7; 3.4; 4.1; 4.2; 4.4) was \u0026lt;4.0, and the coefficient of variation was \u0026gt;0.25, so the experts were consulted again to see if they would agree to their deletion.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eQuestionnaire round 2 (QR2)\u003c/p\u003e\n\u003cp\u003eIn the second round, there was a consensus of expert opinion. Agreed with the language changes proposed in Round 1 for Level 1 Indicator Internship Teaching Content Readiness and Level 2 Indicators 2.2, 2.10, 2.11, and 4.5, and disagreed with the language change for 2.1. All experts agreed to delete 1.7 and 3.4 and suggested retaining the primary indicator of preparedness for emergency management of internship teaching and the secondary indicators 4.1、4.2 and 4.4. After two rounds of correspondence inquiry, a self-evaluation system of emergency management readiness of practice teaching is formed, which includes 5 first-level indicators and 35 second-level indicators, as shown in Table 5.\u003c/p\u003e\n\u003cp\u003eTable 5: Results of the first and second rounds of correspondence\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\" width=\"685\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"59.06432748538012%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.36842105263158%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eImportance rating of indicators\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.567251461988302%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eRatings the readiness in various areas\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003ePrimary and secondary indicators\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003eSD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003eCV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003eSD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e1. Readiness of the organizational structure for teaching internships\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.632\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.684\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.148\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e1.1 Whether there are sound rules and regulations for internship management\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.684\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.671\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.143\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e89.412\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e10.880\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e1.2 Availability of relevant hardware and facilities in line with internship leading\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.526\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.612\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.135\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e88.824\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e12.187\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e1.3 Availability of an internship leadership team\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.421\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.692\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.157\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e86.471\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e15.387\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e1.4 Availability of a selection program for lead teachers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.105\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.809\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.197\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e81.176\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e19.648\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e1.5 Availability of job descriptions for lead teachers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.158\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.688\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.166\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e78.235\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e18.787\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e1.6 Availability of a detailed internship lead syllabus or handbook\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.632\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.597\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.129\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e84.706\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e18.748\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e1.7 Availability of individualized teaching programmes tailored to the needs of the students*a\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e3.737\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.933\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.250\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e63.529\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e30.402\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e1.8 Whether the lead teacher receives regular training in relevant teaching and pharmacy service training\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.368\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.761\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.174\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e77.647\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e18.884\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e2. Teaching content readiness of internship*b\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.789\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.419\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.087\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e2.1 Whether interns are provided with vocational orientation and professional ethics training*b\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.526\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.772\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.171\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e75.294\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e19.722\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e2.2 The content of the pre-service training is well developed, including an introduction to the relevant pharmacy rules and regulations of the hospital and the department, the management rules for interns, and an introduction to the departmental settings and functions of the department*b\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.474\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.841\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.188\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e87.647\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e11.472\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e2.3 Whether there is a detailed time schedule and teaching plan for the progress of internship teaching in the internship teaching department\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.474\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.612\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.137\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e84.118\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e12.277\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e2.4 Availability of training in hospital pharmacy job content and workflow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.526\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.772\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.171\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e90.588\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e11.440\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e2.5 Availability of medicines dispensing skills, management skills and practices\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.421\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.838\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.189\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e88.824\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e13.639\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e2.6 Availability of medication counseling and medication instruction skills and practices\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.263\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.806\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.189\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e78.824\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e19.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e2.7 Availability of pharmacy information technology operating system learning\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.263\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.933\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.219\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e75.294\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e22.394\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e2.8 Availability of PIVAS job profile learning\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.053\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.970\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.239\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e81.176\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e14.090\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e2.9 Availability of training on adverse drug reaction management and reporting process\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.053\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.970\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.239\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e80.588\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e24.102\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e2.10 Whether there are teaching internships of specialized skills for clinical pharmacists*b\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.368\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.955\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.219\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e80.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e21.506\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e2.11 Whether interns are trained in core pharmacist competencies*b\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.316\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.671\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.155\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e72.353\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e22.229\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e2.12 Whether the lead teacher shows humanistic care for the interns in the process of teaching\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.526\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.697\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.154\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e80.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e21.213\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e3. Readiness of the internship model\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.368\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.761\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.174\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e3.1 Whether or not the lead instructor uses a diversified internship teaching model\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.316\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.671\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.155\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e74.118\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e22.377\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e3.2 Whether to rationally arrange the content of teaching according to the length of internship time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.421\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.692\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.157\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e82.941\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e17.235\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e3.3 Whether the content of teaching is organized in accordance with the intern\u0026apos;s practical needs and learning abilities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.053\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.970\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.239\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e74.706\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e17.363\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e3.4 Whether interns have some freedom of time*a\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e3.421\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e1.071\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.313\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e71.176\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e19.327\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e3.5 Whether it is a combination of theoretical and practical model of teaching and learning\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.579\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.507\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.111\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e84.118\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e14.168\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e4. Readiness to assess the effectiveness of internships\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.263\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.806\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.189\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e4.1 Whether interns are consulted to assess each individual\u0026apos;s internship needs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e3.684\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e1.057\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.287\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e70.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e20.917\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e4.2 Whether the learning environment is assessed to meet the needs of the interns\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e3.526\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.905\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.257\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e68.824\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e16.539\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e4.3 Whether or not the intern is assessed on whether the content of the internship meets the needs of the internship\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.816\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.204\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e74.118\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e16.977\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e4.4 Whether interns are assessed to have the appropriate basic knowledge before joining the department\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e3.842\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e1.119\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.291\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e64.118\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e21.523\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e4.5 Whether there is a regular or periodic evaluation of the internship process*b\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.158\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.765\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.184\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e72.941\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e12.127\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e4.6 Whether the assessment of interns includes theoretical examinations and clinical practice tests\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.474\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.513\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.115\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e77.647\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e19.852\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e4.7 Whether there is an evaluation of the effectiveness of the supervisor\u0026apos;s supervision by the internship supervision team\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.158\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.765\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.184\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e69.412\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e25.365\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e4.8 Availability of interns\u0026apos; assessment of the effectiveness of the lead teacher\u0026apos;s guidance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.368\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.761\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.174\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e71.176\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e21.472\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e5. Preparedness for Emergency Management for Internship Leaders\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e3.947\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e1.079\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.273\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e5.1 Whether to establish contact information for interns and lead teachers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.368\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.684\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.157\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e93.529\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e10.572\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e5.2 Availability of two-way feedback channels for problems in the teaching-learning process\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.579\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.607\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.133\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e88.824\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e14.090\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e5.3 Availability of emergency plans for personal safety and health safety\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.579\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.692\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.151\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e84.118\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e15.835\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"58.97810218978102%\" valign=\"top\"\u003e\n \u003cp\u003e5.4 Whether to educate interns on occupational safety and promote self-protection awareness\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e4.526\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.861313868613139%\" valign=\"top\"\u003e\n \u003cp\u003e0.697\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.613138686131387%\" valign=\"top\"\u003e\n \u003cp\u003e0.154\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e90.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.343065693430656%\" valign=\"top\"\u003e\n \u003cp\u003e13.229\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e*a denotes indicator deletion; *b denotes indicator language change;SD denotes standard deviation;CV denotes coefficient of variation\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn QR2, experts were asked to rate the current level of preparedness of China\u0026apos;s internship teaching in terms of each indicator on a scale from 0 to 100. The mean values of readiness for each indicator ranged from 61.118 (\u0026plusmn; 21.523)/100 (whether interns were assessed to have the appropriate basic knowledge before joining the department) to 93.529 (\u0026plusmn; 10.572)/100 (whether contact information between interns and teaching faculty was established). Among them, the readiness for emergency management of internship teaching was the highest, with an average of 89.118; the readiness for organizational structure of internship teaching (average: 81.25) and the readiness for internship teaching content (average: 81.226) were rated higher; The scores for the internship teaching model (average: 77.412) and the readiness for evaluation of internship teaching effects (average: 71.03) were low. Figure 3 shows the correlation between the importance scores and readiness for each indicator of the self-assessment tool for internship teaching in the pharmacy departments of healthcare organizations (r = 0.722, p \u0026lt; 0.0001).\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eIn this study, the experts who participated in the Delphi correspondence were from seven hospitals and two universities in four different provinces and cities in China. In addition, the consulting experts were teachers engaged in teaching and experienced hospital instructors, and the expert authority coefficient was 0.779, which ensured the objectivity and robustness of the results. The Kendall consistency coefficient of the two rounds of correspondence was statistically significant, proving that the constructed self-assessment tool for internship teaching in pharmacy departments of healthcare organizations is reliable. However, experts\u0026apos; ratings of readiness for various aspects of internship teaching varied, indicating that our healthcare organizations need improvement in two areas: the internship teaching model and the assessment of the effectiveness of internship teaching.\u003c/p\u003e\n\u003cp\u003eThe results of this study show that the organizational structure of internship teaching includes the infrastructure and hardware of the internship teaching department, systems related to internship teaching, and the selection and training of teachers. The pharmacy department of a healthcare institution should be well prepared in terms of organizational structure concerning these aspects, providing a sound infrastructure and system for teaching internships, as well as selection criteria and training for teachers. In terms of the organizational structure of internship teaching, the ratings were low for \u0026ldquo;Availability of job descriptions for lead teachers\u0026rdquo; and \u0026ldquo;Whether the lead teacher receives regular training in relevant teaching and pharmacy service training\u0026rdquo;. Our pharmacy graduates lack a clinical rotation training system for residents, legal safeguards and guidelines for action, qualified clinical practice lead teachers, and accredited internship sites\u003csup\u003e[25]\u003c/sup\u003e. In Japan\u003csup\u003e[26]\u003c/sup\u003e, the government has established accreditation standards for internship sites to guarantee effective internships: basic hardware facilities, standardized teacher qualification requirements, and defined training guidelines and assessment programs. In Korea\u003csup\u003e[27-29]\u003c/sup\u003e, universities and hospital pharmacies have cooperated to establish and improve a set of education and assessment models - the hospital pharmacy department and the school pharmacy program work closely together, the hospital pharmacy department is mainly on the students\u0026apos; internship management, and the school supports the hospital pharmacy department, both sides collaborate, and develop together. At present, some large hospitals and large pharmacy chains in China have set up internship bases with schools to receive a large number of interns majoring in pharmacy from higher vocational colleges and universities; However, there is no unified certification standard for the construction of internship bases, and there are no detailed requirements for the hardware of the internship conditions and the experience of the supervising teachers, which makes it difficult to guarantee the effect of internship\u003csup\u003e[30]\u003c/sup\u003e. there is no unified standard for the selection and training of internship instructors in China, and instructors lack assessment indicators and incentives\u003csup\u003e[31]\u003c/sup\u003e. Based on the above analysis, in the future, we need to strengthen the position awareness of the teachers in the ideology; at the ability level, we need to improve the comprehensive ability and level of the teachers; at the system level, we need to improve the access system of the teachers, the evaluation mechanism of the effect of teaching and the construction of the guarantee mechanism. At the institutional level, it is necessary to improve the access system, the evaluation mechanism of the teaching effect, and the construction of the guarantee mechanism\u003csup\u003e[32]\u003c/sup\u003e.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAccording to the results of this study, the content of internship teaching includes professional orientation and ethics training, pre-service training, training in the dispensing department, and practical training in the clinical department. Regarding the teaching content of internship teaching, the interns were rated low in terms of professional orientation and ethics training and pharmacist core competency training as well as the learning of pharmacy information technology operating system. Internship is a critical period for most graduates\u0026apos; career decision-making, and graduation internship is an important way for students to fully understand the content of the work and the current situation of employment, so that they can better choose employment and further education reasonably according to their actual situation, In addition, internship can provide better preparation for future clinical work. Therefore, during the internship period, we should enhance the interns\u0026apos; awareness of the pharmacy profession and their career planning for the future\u003csup\u003e[33, 34]\u003c/sup\u003e. The core competencies of hospital pharmacists refer to the knowledge, skills, judgment, and personal attributes required for pharmacists to provide safe, effective, cost-effective, and ethical patient-centered pharmacy services, including professional practice, coordination and communication, management, professional development, and critical thinking\u003csup\u003e[35-37]\u003c/sup\u003e. Training interns in core pharmacist competencies can enhance pharmacy services. China\u0026apos;s hospital pharmacy services are gradually changing from purely \u0026quot;drug-centered\u0026quot; to \u0026quot;patient-centered\u0026quot;\u003csup\u003e[38]\u003c/sup\u003e. The development of \u0026quot;patient-centered\u0026quot; pharmacy service is still facing the change of service concept, the lack of patients\u0026apos; awareness of pharmacy service, the business level of pharmacy personnel needs to be improved, the establishment of clinical pharmacists, and other issues. Therefore, there is an urgent need for relevant regulations and policies to clearly define the contents of the work and guide the hospital pharmacy services to be perfected towards systematization, standardization, and rationalization\u003csup\u003e[39]\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eThe research results show that internship teaching modes include diversified teaching modes, theory and practice teaching modes, and arranging teaching contents according to the length of internship and different levels of interns. In terms of the teaching mode, the ratings of whether to adopt diversified teaching modes and whether to arrange the teaching contents according to the interns\u0026apos; needs and learning abilities were low. The traditional internship teaching mode is mostly led by the teacher, and the interns are in a passive acceptance state, which weakens the students\u0026apos; motivation to learn and reduces the interns\u0026apos; initiative\u003csup\u003e[40]\u003c/sup\u003e. New teaching methods such as Problem-Based Learning (PBL)\u003csup\u003e[41]\u003c/sup\u003e and Case Based Learning (CBL) can help improve the effectiveness of internships\u003csup\u003e[42]\u003c/sup\u003e. The use of diversified teaching methods stimulates students\u0026apos; motivation and enhances their independent learning and research abilities, giving them good clinical and communication skills, thus improving the effectiveness of the internship\u003csup\u003e[43]\u003c/sup\u003e.The level of interns in China\u0026apos;s pharmacy program varies, and teachers should rationally arrange the content of teaching according to the interns\u0026apos; needs and learning abilities.\u003c/p\u003e\n\u003cp\u003eThe results of this study show that the assessment of the effectiveness of internship teaching should include access assessment, process assessment, outcome assessment, and bidirectional assessment; however, the overall scores in the aspect of the assessment of the effectiveness of internship teaching in China are low, indicating that there is a difference between China\u0026apos;s internship teaching system and that of the developed countries in these aspects:(1) \u0026nbsp;Lack of access assessment. Because of the late start of pharmacy internship teaching in China, the pharmacy departments of medical institutions accept interns at different levels of specialties, undergraduate and master\u0026apos;s degrees, and there is a lack of criteria for access assessment of interns. In Japan, students are required to pass the Pharmacy Common Achievement Test (CBT: Computer-Based Testing and OSCE: Objective Structured Clinical Examination) before participating in pharmacy internships, which prevents students without pharmacist licenses from participating in training site pharmacy internships\u003csup\u003e[26, 44]\u003c/sup\u003e. In the United States, a pharmacist can only become a clinical pharmacist after obtaining a doctor of pharmacy degree, passing the national standardized examination, and then undergoing 1-2 years of residency pharmacist training\u003csup\u003e[45]\u003c/sup\u003e. (2) Defects in process evaluation and result evaluation. China\u0026apos;s pharmacy graduates are generally poor in practical ability, the reason is that the practice education system is not perfect, the domestic teaching hospitals mostly use the traditional written and operational examinations, and there is a lack of perfect assessment and evaluation system when assessing the results of internship\u003csup\u003e[6]\u003c/sup\u003e. Foreign pharmacy internships need to participate in several practical courses, and throughout the entire period of professional learning, the assessment includes daily attendance, network testing, meetings and discussion performance, mentors and classmates evaluation, and other forms of assessment, each part of the results multiplied by the weighting of the final results\u003csup\u003e[46]\u003c/sup\u003e. (3) Look forward to establishing a two-way assessment scheme. Two-way assessment includes the evaluation of the teaching staff and the interns, and the evaluation of the teaching staff is mainly from the interns and the teaching team to make a comprehensive evaluation of the teaching attitude, teaching content, and teaching effect of the teaching staff.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStrengths and limitations\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe strengths of this paper are mainly in the following aspects: 1) This study used a mixed-methods approach, which allowed the indicators of the assessment tool to be derived primarily from the first-hand experiences of interns and lead teachers, enhancing the validity of the tool. 2) The experts participating in this study are from the pharmacy departments of several large comprehensive medical institutions across the country, which guarantees the representativeness and rigor of the study. Of course, several limitations are worth mentioning. First, the self-assessment tool for internship teaching readiness is a dynamic system that will change with the development of hospital pharmacy and the national healthcare reform, and It still needs to be improved and the relevant indexes to make the self-assessment tool more specific and practical in practice. Secondly, this study has not conducted a large-scale empirical study on the self-assessment tool; the next step will be to continue to conduct empirical studies nationwide to test the reliability and operability of the self-assessment tool, and to further improve the index system so that it will be more valuable for application.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis is the first self-assessment tool for internship teaching proposed in China, which can provide a self-examination checklist and improve the level of internship teaching for pharmacy departments in medical institutions. Our study suggests that medical institutions should build a perfect pharmacy internship teaching program from the following aspects: 1. the organizational structure of internship teaching, the internship teaching department should provide perfect infrastructure and hardware, and there should be a system related to internship teaching as well as a program for the selection and training of teachers; 2. the content of the internship teaching should include professional orientation and ethics training, pre-service training, training in the transfer department and practical training in the clinical department; 3. In terms of the mode of internship teaching, there should be diversified modes of internship teaching, and the content of teaching should be reasonably arranged according to the length of internship and interns at different levels; 4. In terms of the evaluation of the effect of internship teaching, there are standards for access evaluation, process evaluation, result evaluation, and two-way evaluation; 5. In terms of the emergency management of internship teaching, there are plans for emergency management and a two-way feedback channel.\u0026nbsp;\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors acknowledge the support of all the interviewees and Correspondence experts who participated in the study\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eZhao Yin designed the study; Zhao Yin and Xuedong Jia conducted the interviews; Huitao Huang and Zhao Yin analyzed the data, Huitao Huang wrote the manuscript. Zhao Yin was particularly involved in the drafting, and revising of the different versions of the manuscript, and final approval of the version to be published. All authors contributed to the study\u0026apos;s conception and design, All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe work was supported by Henan Medical Education Research Project (WJLX2023016)\u0026nbsp;、\u0026nbsp;Henan Provincial Medical Science and Technology Public Welfare Program Soft Science Project,( RKX202302017) and Henan Zhongyuan Medical Science and Technology Innovation Development Foundation(ZYYC202301YB)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the Co-first author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDeclarations\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthics was approved by The First Affiliated Hospital of Zhengzhou University\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe Institutional Review Board approved the protocol (2019-KY-304). Written informed consent was obtained from all the study participants. The study was conducted by the Declaration of Helsinki.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors declare no competing interests.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eGIMENO-JORDA M J, GIMENEZ-PODEROS T, NEGRO-VEGA E, et al. Evaluation of specialized training in hospital pharmacy[J]. Farm Hosp, 2020,44(5): 198-211.\u003c/li\u003e\n\u003cli\u003eSTEEB D R, ZEEMAN J M, BUSH A A, et al. Exploring career development through a student-directed practicum to provide individualized learning experiences[J]. Curr Pharm Teach Learn, 2021,13(5): 500-505.\u003c/li\u003e\n\u003cli\u003eHURST J L. 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BMC Medical Education, 2016,16(1).\u003c/li\u003e\n\u003cli\u003eZHAO W, HE L, DENG W, et al. The effectiveness of the combined problem-based learning (PBL) and case-based learning (CBL) teaching method in the clinical practical teaching of thyroid disease[J]. BMC Med Educ, 2020,20(1): 381.\u003c/li\u003e\n\u003cli\u003eKARIMI R. Interface between problem-based learning and a learner-centered paradigm[J]. Adv Med Educ Pract, 2011,2: 117-125.\u003c/li\u003e\n\u003cli\u003eYAMADA K. [Clinical Training of Pharmacists after Licensure and Career Paths in Medical Institutions][J]. Yakugaku Zasshi, 2022,142(9): 965-969.\u003c/li\u003e\n\u003cli\u003eJOSEPH T, HALE G M, MOREAU C. Training pharmacy residents as transitions of care specialists: a United States perspective[J]. Int J Clin Pharm, 2021,43(3): 756-758.\u003c/li\u003e\n\u003cli\u003eZEITOUN A A, EL Z H, ZEINEDDINE M M. 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J Pharm Pract, 2014,27(1): 89-100.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Internship, Pharmacy departments, Readiness, Mixed study","lastPublishedDoi":"10.21203/rs.3.rs-4222246/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4222246/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjectives\u003c/strong\u003e: Internship in the pharmacy department of medical institutions is an important stage in the growth of pharmacy students. However, the level of internship teaching in pharmaceutical departments of medical institutions in China is not uniform at present, and there is a lack of corresponding readiness evaluation tools. Therefore, the purpose of this study was to construct a self-evaluation tool for the readiness of pharmacy departments in healthcare organizations and to evaluate the readiness of pharmacy departments in healthcare organizations in all aspects of internship teaching.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: This study was conducted using an exploratory mixed approach and was completed in two phases. In the first stage, qualitative research methods were used to conduct semi-structured interviews with hospital pharmacy interns and internship instructors, respectively, in the form of one-on-one or focus groups. The interview data were analyzed by using the theme analysis method to obtain a collection of self-evaluation indicators of internship and teaching readiness in the pharmacy department of public medical institutions. Then, on the basis of literature research, the first draft of the self-assessment tool for internship and teaching readiness in the pharmacy department of medical institutions was compiled. In the second stage, the Delphi method was used to screen the evaluation indexes, a self-evaluation tool for the readiness of the pharmacy department was constructed, and the experts were allowed to score the current status of the internship and teaching in the pharmacy department of medical institutions in China.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: The qualitative research results of the first phase include 5 themes and 22 sub-themes, which serve as the source of indicators for self-assessment tools. In the second stage, the effective recovery rates of the two rounds of expert letters were 90.48% and 89.47% respectively, the expert authority coefficient was 0.779. The self-assessment tool for the readiness of pharmacy departments of healthcare institutions for teaching internships was constructed to include readiness for teaching internships' organization, readiness for teaching internships' content, readiness for teaching internships' modes, readiness for evaluating internships' effects, and readiness for emergency management of internships. The self-assessment tool includes 5 dimensions and 35 secondary indicators. The experts rated the preparedness of pharmacy departments of medical institutions in China in terms of preparedness for teaching internships differently. The score for the preparation degree of emergency management of internship teaching is the highest, the score for organizational structure and teaching content preparation of internship teaching is higher, while the score for the preparation degree of internship teaching mode and teaching effect evaluation is lower.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: The self-assessment tool of the readiness of pharmacy departments in\u003c/p\u003e\n\u003cp\u003emedical institutions to teach internships is scientific and practical and provides a reference basis for the development of the internship teaching program of pharmacy departments in medical institutions.\u003c/p\u003e","manuscriptTitle":"Construction of a self-assessment tool for the readiness of pharmacy departments for internship teaching in public healthcare organizations-An Exploratory Mixed Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-04-15 12:43:38","doi":"10.21203/rs.3.rs-4222246/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-07-12T13:53:13+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-07-05T16:14:21+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-06-28T23:52:39+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"133268912040344242527368474513002755886","date":"2024-06-13T23:19:45+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"14853395697769937063237413747526508314","date":"2024-06-12T15:30:13+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-05-16T11:23:56+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-05-16T11:18:14+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2024-04-10T17:30:46+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-04-10T16:38:56+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medical Education","date":"2024-04-05T10:15:40+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"14e33b40-2b27-4760-ab59-875b3376f27b","owner":[],"postedDate":"April 15th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2024-10-14T16:06:53+00:00","versionOfRecord":{"articleIdentity":"rs-4222246","link":"https://doi.org/10.1186/s12909-024-06088-5","journal":{"identity":"bmc-medical-education","isVorOnly":false,"title":"BMC Medical Education"},"publishedOn":"2024-10-11 15:57:08","publishedOnDateReadable":"October 11th, 2024"},"versionCreatedAt":"2024-04-15 12:43:38","video":"","vorDoi":"10.1186/s12909-024-06088-5","vorDoiUrl":"https://doi.org/10.1186/s12909-024-06088-5","workflowStages":[]},"version":"v1","identity":"rs-4222246","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4222246","identity":"rs-4222246","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}