Scottish Centre for Simulation and Clinical Human Factors, Stirling Road, Scotland, FK5 4WR, Larbert, UK.
NHS Lothian, Scotland, Edinburgh, UK.
BMC Med Educ. 2021 Sep 10;21(1):485. doi: 10.1186/s12909-021-02911-5.
The transfer of training to the workplace is the aim of training interventions. Three primary factors influence transfer: trainee characteristics, training design and work environment influences. Within medical education, the work environment factors influencing transfer of training remain underexplored. Burke and Hutchins' review of training transfer outlined five work environment influences: opportunity to perform, supervisor/peer support, strategic link, transfer climate and accountability. This study aimed to explore the ways in which work environment factors influence the transfer of training for medical trainees.
Internal Medicine Training in Scotland includes a three-day boot camp involving simulation-based mastery learning of procedural skills, immersive simulation scenarios and communication workshops. Following ethical approval, trainees were invited to take part in interviews at least three months after following their boot camp. Interviews were semi-structured, anonymised, transcribed verbatim and analysed using template analysis. Member checking interviews were performed to verify findings.
A total of 26 trainees took part in interviews between January 2020 and January 2021. Trainees reported a lack of opportunities to perform procedures in the workplace and challenges relating to the transfer climate, including a lack of appropriate equipment and resistance to change in the workplace. Trainees described a strong sense of personal responsibility to transfer and they felt empowered to change practice in response to the challenges faced.
This study highlights barriers to transfer of training within the clinical workplace including procedural opportunities, a transfer climate with challenging equipment availability and, at times, an unsupportive workplace culture. Trainees are driven by their own sense of personal responsibility; medical educators and healthcare leaders must harness this enthusiasm and take heed of the barriers to assist in the development of strategies to overcome them.
培训的目的是为了将所学应用于工作场所。有三个主要因素会影响培训的转移：学员的特点、培训设计和工作环境的影响。在医学教育中，影响培训转移的工作环境因素仍未得到充分探索。Burke 和 Hutchins 对培训转移的综述概述了五个工作环境影响因素：执行机会、主管/同行支持、战略联系、转移氛围和问责制。本研究旨在探讨工作环境因素影响医学学员培训转移的方式。
苏格兰内科培训包括为期三天的训练营，涉及基于模拟的程序性技能掌握、沉浸式模拟场景和沟通工作坊。在获得伦理批准后，邀请学员在完成训练营至少三个月后参加访谈。访谈采用半结构化、匿名、逐字转录，并使用模板分析进行分析。进行成员检查访谈以验证研究结果。
2020 年 1 月至 2021 年 1 月期间，共有 26 名学员参加了访谈。学员报告在工作场所缺乏执行程序的机会，并且在转移氛围方面存在挑战，包括缺乏适当的设备和工作场所对变革的抵制。学员描述了一种强烈的个人责任感，他们感到有能力应对面临的挑战，从而改变实践。
本研究强调了临床工作场所培训转移的障碍，包括程序机会、具有挑战性设备可用性的转移氛围以及有时不支持工作场所文化。学员受到自身责任感的驱动；医学教育者和医疗保健领导者必须利用这种热情并注意到这些障碍，以帮助制定克服这些障碍的策略。
