Faculty of Medicine, Imperial College London, London, United Kingdom.
Med Educ Online. 2021 Dec;26(1):1976443. doi: 10.1080/10872981.2021.1976443.
Supporting medical students in their transition to newly qualified doctor is an important educational priority. Clinical Teaching Fellows (CTFs), as both recent graduates and trained educators, are uniquely positioned to suggest curricular enhancements to support preparedness for practice. Our mixed-methods approach involved CTFs across eight UK teaching hospitals. We conducted five activity-oriented focus groups to explore what CTFs felt needed to change to increase preparedness for practice. We analysed these focus groups to create a dataset of their suggestions followed by a survey. The survey invited CTFs to rate and rank these suggestions in relation to their own self-rated preparedness for practice, with qualitative insights into their choices. We explored commonalities and differences between high and low confidence participants, with findings qualitatively illuminated. 24 CTFs attended focus groups from which we identified 28 curriculum items and 10 curriculum agendas. We collected 23 complete survey responses. All confidence groups rated communicating with colleagues and managing working life as unmet needs, whereas core clinical competencies such as history and examination were well met. Participants with low confidence identified more complex clinical competencies including clinical decision making, task prioritisation and end-of-life care as unmet needs, with decision making and prioritisation being the most important. Confident graduates rated higher professional competencies such as quality improvement, career planning and education as unmet needs but of low importance. Graded transition of responsibility was the highest ranked curriculum agenda. Qualitative insights included suggestions for how learning in clinical environments could be enhanced. Our findings suggest that transitioning from student to newly qualified doctor could be supported by graded entrustment and enhanced shadowing opportunities. Other recommendations include prioritising more complex clinical competencies, identifying wellbeing as part of preparedness for practice, equipping students to communicate with colleagues and aligning higher professional competencies with learners' needs.
支持医学生向新合格医生的过渡是一项重要的教育优先事项。临床教学研究员（CTF）作为最近的毕业生和受过培训的教育者，具有独特的地位，可以提出课程增强建议，以支持为实践做好准备。我们采用混合方法，涉及英国八所教学医院的 CTF。我们进行了五次以活动为导向的焦点小组讨论，探讨 CTF 认为需要改变哪些内容以提高实践准备能力。我们对这些焦点小组进行了分析，创建了一个包含他们建议的数据集，然后进行了一项调查。该调查邀请 CTF 根据自己对实践准备的自我评估，对这些建议进行评分和排名，并对他们的选择进行定性分析。我们探讨了高信心和低信心参与者之间的共性和差异，并用定性方法阐明了研究结果。24 名 CTF 参加了焦点小组，从中我们确定了 28 项课程项目和 10 项课程议程。我们收集了 23 份完整的调查回复。所有信心组都将与同事沟通和管理工作生活评为未满足的需求，而历史和检查等核心临床能力则得到了很好的满足。低信心组的参与者确定了更多复杂的临床能力，包括临床决策、任务优先级和临终关怀作为未满足的需求，其中决策和优先级最为重要。有信心的毕业生认为更高的专业能力，如质量改进、职业规划和教育，作为未满足的需求，但重要性较低。分级责任过渡是排名最高的课程议程。定性见解包括关于如何在临床环境中增强学习的建议。我们的研究结果表明，从学生过渡到新合格医生可以通过分级委托和增强影子机会来支持。其他建议包括优先考虑更复杂的临床能力，将幸福感作为实践准备的一部分，使学生具备与同事沟通的能力，并使更高的专业能力与学习者的需求保持一致。
