Department for Health, University of Bath, Claverton Campus, Bath, BA2 7AY, UK.
Institute of Primary Health Care Bern (BIHAM), University of Bern, Bern, Switzerland.
BMC Med Educ. 2019 Apr 11;19(1):104. doi: 10.1186/s12909-019-1531-0.
Negative comments from senior colleagues about specialties, such as general practice and psychiatry, are known to influence trainees' career choice, but little is known about the extent of this influence or the mechanism by which it works. There have been calls to ban these disparaging comments, also known as 'banter'. This study explored how recently qualified doctors make sense of banter in the context of other experiences and information.
Semi-structured telephone interviews were conducted with 24 trainee doctors in their second postgraduate year in South West England. Thematic Analysis was used to code the data and organise them into themes.
Trainees are commonly exposed to banter about the merits of different specialties and those who work in them, but these messages are not received uncritically and are not perceived to be decisive in determining career choice. The views of senior doctors are assimilated with other experiences and information, as trainees strive to assess their 'fit' with a specialty. While banter is seen as positioning specialties in a status hierarchy, other factors such as work-life balance and feeling 'at home' in a specialty are often believed to be more significant factors in career choice. We posited two theories of banter; the 'propaganda model' and the 'person-specialty fit model,' and found the latter to provide a better understanding of how banter informs career choice.
Banter often comprises stereotypes and caricatures, but despite its biases and distortions, it may still aid career choice. The challenge is not to ban banter, but to provide more accurate and reliable knowledge and experiences of what working life is like in different specialties.
众所周知，上级同事对全科医学和精神病学等专业的负面评价会影响受训者的职业选择，但人们对这种影响的程度或其作用机制知之甚少。有人呼吁禁止这种贬低性的评价，也称为“打趣”。本研究探讨了刚毕业的医生如何在其他经验和信息的背景下理解打趣。
在英格兰西南部，对 24 名第二年住院医师进行了半结构化电话访谈。使用主题分析对数据进行编码，并将其组织成主题。
受训者通常会接触到关于不同专业及其从业者的优点的打趣，但这些信息不会被不加批判地接受，也不会被认为是决定职业选择的决定性因素。上级医生的观点与其他经验和信息融合在一起，因为受训者努力评估自己与专业的“契合度”。虽然打趣将专业定位在一个等级制度中，但其他因素，如工作与生活的平衡以及在专业中感到“自在”，通常被认为是职业选择的更重要因素。我们提出了两种打趣理论；“宣传模型”和“人与专业契合模型”，并发现后者提供了对打趣如何影响职业选择的更好理解。
打趣通常包含刻板印象和漫画形象，但尽管存在偏见和扭曲，它仍可能有助于职业选择。挑战不在于禁止打趣，而在于提供更准确和可靠的关于不同专业工作生活的知识和经验。
