Perera D P, Mohanna K
Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka.
University of Worcester, Worcester, UK.
Educ Prim Care. 2021 Jan;32(1):34-42. doi: 10.1080/14739879.2020.1836520. Epub 2020 Nov 27.
Undergraduate medical education and foundation training are still largely hospital based. General practice trainees also spend nearly half of their speciality training in hospitals. : To explore adaptation experiences of general practice speciality trainees throughout the training. : Semi-structured participant-observer interviews with 18 purposively selected trainees on the East Staffordshire vocational training scheme, observation, stakeholder discussions and concurrent inductive thematic analysis. : Undergraduate and early general practice experience during speciality training, general practice trainer role modelling and mastering core general practice skills, facilitated transition. An inclusive and supportive general practice environment, facilitating engagement with a community of practice involving peers, general practice trainers and vocational training programme fostered belongingness. A reduced sense of belongingness during hospital rotations impacted on training and work. Building bridging social connections, personal agency initiatives to bring general practice relevance into hospital training, signposting to general practice relevant duties and mastery of secondary care relevant competencies helped gain belongingness in hospital. While some international graduates required assistance in specific areas; overall, general practice trainees had optimistic views of their future. Conclusion: The main contribution of this study was to relate the adaptation experiences of trainees to learning and practice based on Wenger's communities of practice to enable a better understanding of how they can be influenced to enhance training.: CoP: Community of practice; GP: General practice; GPST: General practice speciality trainee; M: Male; F: Female; ST1: First-year GPST; ST2: Second-year GPST; ST3: Third-year GPST; UKG: UK-based primary medical qualification; IMG: Non-UK primary medical qualification.
本科医学教育和基础培训在很大程度上仍以医院为基础。全科医学培训生在其专科培训中也有近一半时间是在医院度过的。：探索全科医学专科培训生在整个培训过程中的适应经历。：对18名从东斯塔福德郡职业培训计划中特意挑选出的培训生进行半结构化的参与式观察访谈、观察、利益相关者讨论以及同步归纳主题分析。：专科培训期间的本科和早期全科医学经历、全科医学培训师的榜样作用以及掌握核心全科医学技能，促进了转变。一个包容且支持性的全科医学环境，促进了与包括同行、全科医学培训师和职业培训项目在内的实践社区的互动，培养了归属感。在医院轮转期间归属感的降低对培训和工作产生了影响。建立桥梁性的社会联系、将全科医学相关性引入医院培训的个人主动行动、指明与全科医学相关的职责以及掌握与二级医疗相关的能力，有助于在医院获得归属感。虽然一些国际毕业生在特定领域需要帮助；总体而言，全科医学培训生对他们的未来持乐观态度。结论：本研究的主要贡献在于将培训生的适应经历与基于温格实践社区的学习和实践联系起来，以便更好地理解如何能够影响他们以加强培训。：CoP：实践社区；GP：全科医学；GPST：全科医学专科培训生；M：男性；F：女性；ST1：一年级GPST；ST2：二年级GPST；ST三：三年级GPST；UKG：英国初级医学资格；IMG：非英国初级医学资格。
