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医院和社区环境中初级医生精神科实习:一项现象学研究

Junior doctor psychiatry placements in hospital and community settings: a phenomenological study.

作者信息

Beattie Sharon, Crampton Paul E S, Schwarzlose Cathleen, Kumar Namita, Cornwall Peter L

机构信息

Medical Education Faculty, Tees, Esk and Wear Valleys NHS Foundation Trust, Middlesbrough, UK.

Monash Center for Scholarship in Health Education (MCSHE), Monash University, Melbourne, Victoria, Australia.

出版信息

BMJ Open. 2017 Sep 27;7(9):e017584. doi: 10.1136/bmjopen-2017-017584.

Abstract

OBJECTIVES

The proportion of junior doctors required to complete psychiatry placements in the UK has increased, due in part to vacant training posts and psychiatry career workforce shortages, as can be seen across the world. The aim of this study was to understand the lived experience of a Foundation Year 1 junior doctor psychiatry placement and to understand how job components influence attitudes.

DESIGN

The study was conducted using a cross-sectional qualitative phenomenological approach.

SETTING

Hospital and community psychiatry department settings in the North East of England, UK.

PARTICIPANTS

In total, 14 Foundation Year 1 junior doctors were interviewed including seven men and seven women aged between 23 and 34 years. The majority had completed their medical degree in the UK and were White British.

RESULTS

The lived experience of a junior doctor psychiatry placement was understood by three core themes: exposure to patient recovery, connectedness with others in the healthcare team and subjective interpretations of psychiatry. The experiences were moderated by instances of role definition, reaction to the specialty and the organisational fit of the junior doctor capacity in the specialty.

CONCLUSIONS

The study reinforces and adds to the literature by identifying connectedness as being important for both job satisfaction and morale, which is currently damaged within the junior doctor population. The study provides in-depth insights into the lived experience of psychiatry placements and can be taken forward by educationalists to ensure the placements are meaningful experiences for junior doctors by developing role definition, belonging, structure and psychiatric care responsibility.

摘要

目的

在英国,要求完成精神病学实习的初级医生比例有所增加,部分原因是培训岗位空缺以及精神病学职业劳动力短缺,这种情况在全球都可见到。本研究的目的是了解一名一年级基础培训初级医生在精神病学实习中的实际经历,并了解工作内容如何影响态度。

设计

本研究采用横断面定性现象学方法进行。

地点

英国英格兰东北部的医院和社区精神病学部门。

参与者

总共采访了14名一年级基础培训初级医生,包括7名男性和7名女性,年龄在23岁至34岁之间。大多数人在英国完成了医学学位,是英国白人。

结果

初级医生精神病学实习的实际经历可通过三个核心主题来理解:接触患者康复、与医疗团队中的其他人建立联系以及对精神病学的主观解读。这些经历受到角色定义、对该专业的反应以及初级医生在该专业中的能力与组织契合度等情况的调节。

结论

该研究通过将建立联系确定为对工作满意度和士气都很重要的因素,强化并补充了相关文献,而目前初级医生群体中的工作满意度和士气受到了损害。该研究深入洞察了精神病学实习的实际经历,教育工作者可以借鉴,通过明确角色定义、归属感、结构和精神科护理责任,确保实习对初级医生来说是有意义的经历。

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