Monash Centre for Scholarship in Health Education (MCSHE), Faculty of Medicine, Nursing & Health Sciences, Monash University, Clayton, Vic., Australia.
College of Science, Health, Engineering & Education, Murdoch University, Murdoch, WA, Australia.
Med Educ. 2021 Sep;55(9):1078-1090. doi: 10.1111/medu.14475. Epub 2021 Mar 28.
Although preparedness for practice (P4P) has been variously described, little shared understanding exists about what P4P is across the health professions. How P4P is conceptualised matters, because this shapes how stakeholders think, talk about and act towards it. Further, multiple understandings can result in diverse expectations for graduate performance. This study therefore explores health care learners' solicited and unsolicited conceptualisations of P4P over their early graduate transition.
We conducted longitudinal qualitative research including individual and group entrance interviews (phase 1: n = 35), longitudinal audio-diaries (phase 2: n = 30), and individual and group exit interviews (phase 3: n = 22) with learners from four disciplines (dietetics, medicine, nursing and pharmacy). We employed framework analysis to interrogate data cross-sectionally and longitudinally.
We found 13 conceptualisations of P4P (eg knowledge, confidence), broadly similar across the disciplines. We found some conceptualisations dominant in both solicited and unsolicited talk (eg skills), some dominant only in solicited talk (eg competence) and others dominant only in unsolicited talk (eg experience). Although most conceptualisations appeared relatively stable across time, some appeared to dominate at certain time points only (eg employability and skills in phases 1 and 2, and competence in phase 3).
This novel study extends previous uniprofessional work by illustrating a broader array of conceptualisations, differences between professions, solicited versus unsolicited talk and longitudinal cohort patterns. We encourage health care educators to discuss these different P4P understandings in graduate transition interventions. Further research is needed to explore other stakeholders' conceptualisations, and over a duration beyond the early graduate transition.
尽管实践准备(P4P)已经有多种描述,但对于健康专业人士而言,对 P4P 的理解却很少有共识。P4P 的概念很重要,因为它影响利益相关者对其的思考、讨论和行动方式。此外,多种理解可能导致对毕业生表现的不同期望。因此,本研究探讨了医疗保健学习者在早期毕业过渡期间对 P4P 的主动和被动概念化。
我们进行了纵向定性研究,包括个体和小组入学访谈(第 1 阶段:n=35)、纵向音频日记(第 2 阶段:n=30)以及来自四个学科(营养学、医学、护理和药学)的学习者的个体和小组结业访谈(第 3 阶段:n=22)。我们采用框架分析对数据进行跨阶段和纵向分析。
我们发现了 13 种 P4P 的概念化(例如知识、信心),在各学科中大致相似。我们发现一些概念化在主动和被动谈话中都占据主导地位(例如技能),一些只在主动谈话中占据主导地位(例如能力),而另一些则只在被动谈话中占据主导地位(例如经验)。尽管大多数概念化在整个时间内相对稳定,但有些概念化似乎仅在特定时间点占据主导地位(例如在第 1 阶段和第 2 阶段的就业能力和技能,以及第 3 阶段的能力)。
这项新的研究通过说明更广泛的概念化、不同专业之间的差异、主动和被动谈话以及纵向队列模式,扩展了以前的单一专业工作。我们鼓励医疗保健教育工作者在毕业生过渡干预中讨论这些不同的 P4P 理解。需要进一步研究来探索其他利益相关者的概念化,以及在早期毕业过渡之外的更长时间内进行研究。