Birden Hudson, Barker Jane, Wilson Ian
a James Cook University , Australia .
d University of Sydney , Australia.
Med Teach. 2016 Sep;38(9):946-56. doi: 10.3109/0142159X.2015.1114594. Epub 2015 Dec 22.
We interviewed graduates from the first two cohorts of a postgraduate medical program that had a senior year longitudinal integrated clerkship (LIC) in a practice setting in rural New South Wales, Australia to determine how well their training prepared them to be junior doctors (3-4 years after graduation), and what aspects of that training they thought were particularly useful.
In-depth interviews.
Fourteen junior doctors were interviewed. Participants reported feeling well prepared in ability to develop close relationships with clinical supervisors, good clinical and procedural skills, ability to work autonomously and work in teams, knowledge of health systems, ability to ensure self-care, and professionalism. Consensus view was that a rural placement was an excellent way to learn medicine for a variety of reasons including relationships with clinicians, less competition for access to patients, and opportunities to extend their clinical skills and act up to intern level.
The advantages we found in the training these junior doctors received which prepared them well for internship were integral both to the longitudinal, unstructured placement, and to the fact that it was carried out in a rural area. The two aspects of these placements appear to act synergistically, reinforcing the learning experience.
我们采访了澳大利亚新南威尔士州农村地区一个研究生医学项目前两批毕业生,该项目在大四设有纵向综合实习(LIC),以确定他们的培训在多大程度上使他们为成为初级医生(毕业后3 - 4年)做好准备,以及他们认为该培训的哪些方面特别有用。
深度访谈。
采访了14名初级医生。参与者报告称,他们在与临床督导建立密切关系的能力、良好的临床和操作技能、自主工作和团队协作能力、卫生系统知识、自我保健能力以及职业素养方面都感觉准备充分。大家一致认为,农村实习是学习医学的绝佳方式,原因有多种,包括与临床医生的关系、接触患者的竞争较小,以及有机会扩展临床技能并承担实习医生级别的工作。
我们发现这些初级医生接受的培训对他们实习准备充分,其优势既体现在纵向、非结构化的实习安排上,也体现在实习在农村地区进行这一事实上。这些实习安排的两个方面似乎协同作用,强化了学习体验。