Lempp Heidi, Cochrane Mac, Rees John
Guy's, King's and St, Thomas' School of Medicine, King's College, London Sherman Education Centre, Guy's Hospital, London SE1 9RT, UK.
BMC Med Educ. 2005 Mar 9;5(1):10. doi: 10.1186/1472-6920-5-10.
Following the implementation of a new final Year 5 curriculum in one medical school we carried out a study to explore the experience of the transition from final student year to Pre-Registration House Officer (PRHO). This study looks at the experiences of two successive cohorts of PRHOs in relation to team work, support and shared responsibility in their transition from final year students to qualified doctors. The involvement of PRHOs in teams is likely to change in the development of Foundation programmes.
A qualitative study with semi-structured interviews with 33 PRHOs, stratified by gender, ethnicity and maturity, from two study cohorts, qualifying in 2001 and 2002, from one medical school in the UK, in their first three months following medical graduation.
Most PRHOs reported positive experiences for their inclusion as a full member of their first ward teams. This contributed to their increasing confidence and competence in this early period of career transition. However, a number of organisational barriers were identified, e.g. incomplete teams, shift work, which produced problems in their integration for one third of newly qualified doctors.
Recently introduced policies, intended to improve the working lives of newly qualified doctors have produced both benefits and unintended adverse impacts on PRHOs. The changes of the new PRHO Foundation programme will have further impact. Foundation doctors may need to relate to wider teams with more interaction and less protection. Such changes will need to be managed carefully to protect the PRHO at a vulnerable time.
在一所医学院实施新的五年级末课程后,我们开展了一项研究,以探索从学生最后一年过渡到注册前住院医师(PRHO)阶段的经历。本研究考察了连续两届PRHO在从最后一年学生过渡到合格医生过程中,在团队合作、支持和共同责任方面的经历。在基础课程的发展过程中,PRHO在团队中的参与情况可能会发生变化。
采用定性研究方法,对来自英国一所医学院、分别于2001年和2002年毕业的两个研究队列中的33名PRHO进行半结构化访谈,访谈在他们医学毕业后的头三个月进行,按性别、种族和成熟度进行分层。
大多数PRHO报告称,作为首批病房团队的正式成员被接纳,他们有积极的体验。这有助于他们在职业过渡的早期阶段增强信心和能力。然而,也发现了一些组织障碍,例如团队不完整、轮班工作,这给三分之一的新合格医生的融入带来了问题。
最近出台的旨在改善新合格医生工作生活的政策,对PRHO既有好处,也产生了意想不到的不利影响。新的PRHO基础课程的变化将产生进一步的影响。基础医生可能需要与更广泛的团队建立联系,互动更多,保护更少。需要谨慎管理这些变化,以在脆弱时期保护PRHO。