Ottrey Ella, Rees Charlotte E, Kemp Caitlin, Lyons Kayley M, Brock Tina P, Leech Michelle, Monrouxe Lynn V, Palermo Claire
Monash Centre for Scholarship in Health Education (MCSHE), Faculty of Medicine, Nursing & Health Sciences, Monash University, Clayton, VIC, Australia.
School of Health Sciences, College of Health, Medicine & Wellbeing, The University of Newcastle, Callaghan, NSW, Australia.
Adv Health Sci Educ Theory Pract. 2025 Jun;30(3):711-734. doi: 10.1007/s10459-024-10372-w. Epub 2024 Sep 16.
Despite extensive preparedness literature, existing studies fail to adequately explore healthcare graduates' feelings of preparedness longitudinally across new graduate transition journeys, nor do they compare different healthcare professions to ascertain what opportunities exist for multiprofessional transition interventions. Therefore, this Australian study, underpinned by temporal theory, explores the preparedness transitions of medicine and pharmacy graduates. Our 6-month qualitative longitudinal study involved 12 medicine and 7 pharmacy learners after purposive sampling. They participated in an entrance interview before starting internship, longitudinal audio-diaries during their first three months of internship, and an exit interview. Framework analysis explored patterns in the data cross-sectionally and longitudinally for the whole cohort (thinking over time), with pen portraits illustrating individuals' journeys (thinking through time). Preparedness and unpreparedness narratives involved practical skills and tasks, interpersonal skills, knowledge, and professional practice for medicine and pharmacy. However, narratives for practical skills and tasks, and professional practice were dominant amongst medicine graduates, while narratives for interpersonal skills and knowledge were dominant amongst pharmacy graduates. We found numerous cohort changes in feelings of preparedness over time, but the illustrative pen portraits demonstrated the complexities and nuances through time, including feelings of preparedness before internship becoming unpreparedness during internship (e.g., cannulas), improving preparedness through time (e.g., cover shifts), and persistent feelings of unpreparedness (e.g., patient interactions). While our cross-sectional findings are reasonably consistent with existing research, our comparative and longitudinal findings are novel. We recommend that educators build learners' preparedness through uniprofessional transition interventions involving practical skills and tasks, and professional practice in medicine, and interpersonal skills and knowledge in pharmacy. More importantly, we recommend multiprofessional transition interventions for medicine and pharmacy learners before internship focusing on knowledge, and during internship focusing on practical skills and tasks.
尽管有大量关于准备情况的文献，但现有研究未能充分纵向探究医疗保健专业毕业生在新毕业生过渡阶段的准备感受，也未对不同医疗保健专业进行比较，以确定多专业过渡干预存在哪些机会。因此，这项以时间理论为基础的澳大利亚研究，探讨了医学和药学专业毕业生的准备情况转变。我们为期6个月的定性纵向研究在目的抽样后，涉及12名医学专业和7名药学专业的学习者。他们在开始实习前参加了入学面试，在实习的前三个月进行了纵向音频日记记录，并参加了离职面试。框架分析从横断面和纵向上探究了整个队列数据中的模式（随时间思考），人物特写则展示了个人的经历（贯穿时间思考）。准备充分和准备不足的叙述涉及医学和药学的实践技能与任务、人际技能、知识和专业实践。然而，实践技能与任务以及专业实践的叙述在医学专业毕业生中占主导，而人际技能和知识的叙述在药学专业毕业生中占主导。我们发现，随着时间推移，队列在准备感受方面有许多变化，但具有代表性的人物特写展示了随着时间推移的复杂性和细微差别，包括实习前的准备感在实习期间变为准备不足（例如静脉套管插入）、随着时间推移准备情况得到改善（例如替班）以及持续的准备不足感（例如与患者互动）。虽然我们的横断面研究结果与现有研究相当一致，但我们的比较性和纵向研究结果是新颖的。我们建议教育工作者通过针对医学专业的实践技能与任务以及专业实践，和针对药学专业的人际技能与知识的单专业过渡干预来培养学习者的准备能力。更重要的是，我们建议在实习前针对医学和药学专业学习者进行多专业过渡干预，重点是知识，在实习期间则重点关注实践技能与任务。
