Department of Learning, Informatics, Management, and Ethics, Karolinska Institutet, Stockholm, Sweden.
Department of Ethnology, History of Religions and Gender Studies, Stockholm University, Stockholm, Sweden.
PLoS One. 2023 Mar 15;18(3):e0282317. doi: 10.1371/journal.pone.0282317. eCollection 2023.
This study explores the establishment experiences of physicians in the Swedish medical context who have been trained outside the European Union. The study used a qualitative approach with a quasi-longitudinal research design. The data were gathered via 63 semi-structured interviews with migrant physicians at three different periods. The data were analysed using qualitative thematic content analysis, adopting the theory on the context dependence of knowledge, which includes different forms of knowledge as sensitising concepts in the discussion. The MPs perceived themselves as having the medical knowledge (encoded knowledge) needed to work in Sweden. However, they perceived that they needed to develop knowledge of how to use the encoded knowledge in the Swedish medical context. The needed knowledge was thus foremost encultured, embedded, embodied, or embrained. The results are presented in the following themes: medical knowledge; knowledge of the healthcare system and its variations; knowledge of administrative routines; understanding the role as a physician, interaction and hierarchies between physicians and other healthcare staff; understanding the interaction and hierarchies between physicians and patients; and knowledge of the Swedish language. Knowledge, as described in the themes, function as gateways that needs to be unlocked for practising medicine in a new context. Embedded, embrained, embodied, and encultured knowledge interact and are interdependent, and the different forms of knowledge work as gateways to other forms of knowledge, and thus, they open for each other. However, to pass the gateways, managing the common language is important. We conclude that language is an enabler and a key to unlocking gateways to practise.
本研究探讨了在欧盟以外接受培训的瑞典医学背景下的医生的建立经验。该研究采用了定性方法和准纵向研究设计。通过对三个不同时期的 63 名移民医生进行 63 次半结构化访谈收集了数据。采用基于知识语境依赖性的理论对数据进行了定性主题内容分析，该理论将不同形式的知识作为讨论中的敏感概念。MPs 认为自己拥有在瑞典工作所需的医学知识（编码知识）。然而，他们认为自己需要发展在瑞典医学背景下使用编码知识的知识。因此，所需的知识主要是被文化内化、嵌入、体现或脑化。研究结果以以下主题呈现：医学知识；医疗系统及其变化的知识；行政程序的知识；理解作为医生的角色、医生与其他医护人员之间的互动和层级关系；理解医生与患者之间的互动和层级关系；以及瑞典语知识。主题中描述的知识充当了在新环境中行医所需的解锁的门户。嵌入的、脑化的、体现的和文化内化的知识相互作用且相互依存，不同形式的知识充当通向其他形式知识的门户，因此，它们相互开放。然而，要通过门户，管理通用语言很重要。我们的结论是，语言是解锁实践的门户的推动者和关键。
