BACKGROUND: Traditional observer-based medical internships can inadequately prepare graduates for independent clinical practice. In departments without resident physicians, the absence of intermediate supervisory layers creates both challenges and unique opportunities for educational innovation. This study aimed to evaluate the effectiveness of the Responsibility-Integrated Task-Based Education (RITBE) model in enhancing interns' self-reported occupational self-efficacy and professionalism attitudes compared with traditional observer-based training. METHODS: A quasi-experimental pretest-posttest study with a non-equivalent control group was conducted at Afyonkarahisar Health Sciences University Hospital from July 2024 through July 2025. The intervention group (n = 112) received RITBE featuring primary patient assignments, progressive autonomy, and intensive mentorship guided by a departmental study and learning guide. The control group (n = 75) received traditional observer-based training in General Pediatrics. Primary outcomes included occupational self-efficacy beliefs and professionalism attitudes assessed using validated instruments administered at rotation start and completion. RESULTS: The RITBE group demonstrated significantly greater improvements in occupational self-efficacy (mean change + 18.7 vs. +3.2, p < 0.001) and professionalism attitudes (mean change + 14.3 vs. +2.8, p < 0.001) compared with controls. The empathy-humanism subscale showed greater improvement in the RITBE group (Cohen's d = 0.64, 95% CI: 0.32-0.95, p < 0.001), as did the responsibility subscale (Cohen's d = 0.67, 95% CI: 0.35-0.99, p = 0.002). Interest in pediatric hematology-oncology subspecialization was higher in the RITBE group at rotation completion (42.0% vs. 8.0%, OR = 8.31, 95% CI: 3.36-20.54, p < 0.001). No adverse safety events attributable to intern clinical activities were identified through institutional monitoring systems. CONCLUSIONS: The RITBE model was associated with significantly greater improvements in self-reported occupational self-efficacy and professionalism attitudes compared with traditional training. This structured approach offers a potentially viable framework for medical education, particularly in departments without resident physicians, though confirmation in diverse settings is needed.
Eker et al. (Thu,) studied this question.