Chang Gung Medical Education Research Centre (CG-MERC), Chang Gung Memorial Hospital, Gueishan, Taiwan.
Cardiff University, Cardiff Unit for Research and Evaluation in Medical and Dental Education (CUREMeDE), Cardiff, UK.
BMJ Open. 2018 Aug 29;8(8):e023146. doi: 10.1136/bmjopen-2018-023146.
While previous studies have begun to explore newly graduated junior doctors' preparedness for practice, findings are largely based on simplistic survey data or perceptions of newly graduated junior doctors and their clinical supervisors alone. This study explores, in a deeper manner, multiple stakeholders' conceptualisations of what it means to be prepared for practice and their perceptions about newly graduated junior doctors' preparedness (or unpreparedness) using innovative qualitative methods.
A multistakeholder, multicentre qualitative study including narrative interviews and longitudinal audio diaries.
Four UK settings: England, Northern Ireland, Scotland and Wales.
Eight stakeholder groups comprising n=185 participants engaged in 101 narrative interviews (27 group and 84 individual). Twenty-six junior doctors in their first year postgraduation also provided audio diaries over a 3-month period.
We identified 2186 narratives across all participants (506 classified as 'prepared', 663 as 'unprepared', 951 as 'general'). Seven themes were identified; this paper focuses on two themes pertinent to our research questions: (1) explicit conceptualisations of preparedness for practice; and (2) newly graduated junior doctors' preparedness for the General Medical Council's (GMC) . Stakeholders' conceptualisations of preparedness for practice included short-term () and long-term preparedness, alongside being prepared for practical and emotional aspects. Stakeholders' perceptions of medical graduates' preparedness for practice varied across different GMC outcomes for graduates (eg, Doctor as Scholar and Scientist, as Practitioner, as Professional) and across stakeholders (eg, newly graduated doctors sometimes perceived themselves as prepared but others did not).
Our narrative findings highlight the complexities and nuances surrounding new medical graduates' preparedness for practice. We encourage stakeholders to develop a shared understanding (and realistic expectations) of new medical graduates' preparedness. We invite medical school leaders to increase the proportion of time that medical students spend participating meaningfully in multiprofessional teams during workplace learning.
虽然之前的研究已经开始探索新毕业的初级医生的实践准备情况，但研究结果主要基于简单的调查数据或新毕业的初级医生及其临床主管的看法。本研究采用创新的定性方法，更深入地探讨了多个利益相关者对实践准备的概念化理解，以及他们对新毕业的初级医生准备情况（或不准备情况）的看法。
一项多利益相关者、多中心的定性研究，包括叙事访谈和纵向音频日记。
英国的四个地点：英格兰、北爱尔兰、苏格兰和威尔士。
包括 n=185 名参与者的八个利益相关者群体，参与了 101 次叙事访谈（27 次小组访谈和 84 次个人访谈）。26 名刚毕业的初级医生在毕业后的第一个月也提供了为期 3 个月的音频日记。
我们在所有参与者中识别了 2186 个叙事（506 个被归类为“准备”，663 个被归类为“不准备”，951 个被归类为“一般”）。确定了七个主题；本文重点介绍与我们的研究问题相关的两个主题：（1）对实践准备的明确概念化；（2）新毕业的初级医生对医学总会（GMC）的准备情况。利益相关者对实践准备的概念化包括短期（）和长期准备，以及对实际和情感方面的准备。利益相关者对医学生实践准备情况的看法因毕业生的不同 GMC 结果（例如，医生作为学者和科学家、作为从业者、作为专业人员）和利益相关者（例如，新毕业的医生有时认为自己有准备，但其他人则没有）而有所不同。
我们的叙事研究结果强调了新毕业的医学生实践准备情况的复杂性和细微差别。我们鼓励利益相关者就新医学生的准备情况达成共同的理解（和现实期望）。我们邀请医学院领导增加医学生在工作场所学习期间有意义地参与多专业团队的时间比例。
