Winderbaum Joelle, Coventry Linda L
School of Nursing and Midwifery, Edith Cowan University, Perth, Australia.
Med Educ. 2024 Jun;58(6):687-696. doi: 10.1111/medu.15299. Epub 2024 Jan 14.
The transition from medical student to first-year doctor is notoriously difficult, yielding a high rate of transition failure, burn-out and mental health deterioration. Doctors in this cohort experience unique challenges during this time, which manifest through performance gaps, issues of professional identity, new occupational pressures, and cultural expectations. Mentoring programs are commonly utilised in the medical profession to foster personal and professional development and improve psychosocial well-being and career satisfaction. However, there exist no systematic reviews examining the use of mentorship specifically for the first-year doctor cohort, given the unique transition challenges faced by this vulnerable group.
Due to their transition difficulties, evaluate the research on mentorship specifically for first-year doctors, and identify the emerging themes that can inform the benefits to this group, the barriers that impede program implementation and the facilitators that contribute to successful mentorship programs for this cohort.
The PEO (population, exposure outcome) framework was adopted to develop the research inquiry, after which, a systematic review was conducted, adhering to PRISMA guidelines. The search strategy was conducted with assistance from an experienced university librarian. Screening and selection were completed independently against inclusion/exclusion criteria, by two reviewers. The methodological quality of included studies was assessed using Joanna Briggs critical appraisal instruments. Data sources used included Web of Science Medline, Ebsco Cinahl Plus, Scopus, Web of Science Core Collection and Ovid Journals. Search parameters were restricted to English language and peer-reviewed; date range was unobstructed up to 26 August 2022.
A total of 4137 articles were retrieved, with 13 considered to have met full inclusion criteria. An integrative review synthesis identified three major themes; benefits of mentoring for first-year doctors, intrinsic and extrinsic barriers to mentoring programs and facilitating factors that improve successful program implementation.
First-year doctors report untenable and highly strenuous working conditions, that result in poor mental health and high attrition rates. Formalised, near-peer, tier mosaic mentoring programs provide significant psychosocial and career benefits to this cohort specifically, bridge the training gap from medical student to first-year doctor and ameliorate patterns of intergenerational bullying, hierarchy and emotional inhibition. However, mentorship is inextricably interrelated to societal-cultural considerations of identity. Mentorship alone cannot overcome endemic cultural challenges within medicine without broader systemic change; however, programs are a valuable option towards positive support for first-year doctors.
从医学生到初任医生的过渡异常艰难，过渡失败、职业倦怠和心理健康恶化的发生率很高。这一群体的医生在此期间面临着独特的挑战，表现为绩效差距、职业认同问题、新的职业压力和文化期望。指导计划在医学领域普遍被用于促进个人和职业发展，改善心理社会福祉和职业满意度。然而，鉴于这一弱势群体面临的独特过渡挑战，目前尚无系统综述专门研究针对初任医生群体的指导计划的使用情况。
鉴于初任医生在过渡过程中面临的困难，评估专门针对初任医生的指导研究，并确定能为该群体带来益处的新出现的主题、阻碍计划实施的障碍以及有助于该群体成功实施指导计划的促进因素。
采用PEO（人群、暴露、结局）框架来开展研究询问，之后，按照PRISMA指南进行了系统综述。检索策略在一位经验丰富的大学图书馆员的协助下进行。筛选和选择由两位评审员根据纳入/排除标准独立完成。使用乔安娜·布里格斯批判性评价工具评估纳入研究的方法学质量。使用的数据源包括科学网Medline、EBSCO Cinahl Plus、Scopus、科学网核心合集和Ovid期刊。检索参数限于英语语言和同行评审；日期范围截至2022年8月26日无限制。
共检索到4137篇文章，其中13篇被认为完全符合纳入标准。综合综述分析确定了三个主要主题；指导对初任医生的益处、指导计划的内在和外在障碍以及改善计划成功实施的促进因素。
初任医生报告称工作条件难以维持且极为艰苦，导致心理健康状况不佳和高流失率。正式的、近同伴的、分层镶嵌式指导计划尤其能为这一群体带来显著的心理社会和职业益处，弥合从医学生到初任医生的培训差距，并改善代际欺凌、等级制度和情感抑制模式。然而，指导与身份认同的社会文化考量有着千丝万缕的联系。如果没有更广泛的系统性变革，仅靠指导无法克服医学领域内普遍存在的文化挑战；然而对于初任医生而言，指导计划是提供积极支持的宝贵选择。
