Discipline of General Practice, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia
Discipline of General Practice, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia.
Fam Med Community Health. 2024 Oct 12;12(4):e003002. doi: 10.1136/fmch-2024-003002.
Transitions are a period and a process, through which there is a longitudinal adaptation in response to changing circumstances in clinical practice and responsibilities. While the experience of the transition in medical student learning and in hospital-based specialty training programmes are well described and researched, the experience of the transition in community-based postgraduate general practitioner (GP) training has not been described comprehensively.
We aimed to identify, and categorise, the formative experiences of transitions in GP training and their impacts on personal and professional development.
We adopted Levac 's scoping review methodology. Of 1543 retrieved records, 76 were selected for data extraction. Based on a combined model of the socioecological and multiple and multi-dimensional theories of transitions, data relating to the experiences of transitions were organised into contextual themes: being physical, psychosocial, organisational culture and chronological.
Empirical studies focused on general practice trainees or training, that discussed the transitions experienced in general practice training and that were published in English were included.
PubMed, MEDLINE and Web of Science databases were searched in January 2024 with no date limits for empirical studies on the transition experiences of GP into, and through, training.
Our findings describe context-dependent formative experiences which advance, or impede, learning and development. Time is a significant modulator of the factors contributing to more negative experiences, with some initially adverse experiences becoming more positive. Identification of the inflection point that represents a shift from initially adverse to more positive experiences of transitions may help moderate expectations for learning and performance at different stages of training.
Challenges in training can either advance development and contribute positively to professional identity formation and clinical competency, or detract from learning and potentially contribute to burnout and attrition from training programmes. These findings will assist future research in identifying predictive factors of positive and adverse experiences of transitions and may strengthen existing and nascent GP training programmes. The findings are transferable to other community-based specialty training programmes.
我们旨在确定和分类全科医生培训中过渡的形成性经验及其对个人和专业发展的影响。
我们采用了 Levac 的范围综述方法。在 1543 条检索记录中，有 76 条被选作数据提取。基于过渡的社会生态和多维度理论的综合模型，与过渡经历相关的数据被组织成背景主题：身体、心理社会、组织文化和时间。
专注于全科医生受训者或培训的实证研究，讨论全科医生培训中经历的过渡，并且以英文发表的研究。
2024 年 1 月在 PubMed、MEDLINE 和 Web of Science 数据库中搜索了关于全科医生过渡到培训和贯穿培训的经验的实证研究，没有时间限制。
我们的研究结果描述了促进或阻碍学习和发展的与背景相关的形成性经验。时间是影响更负面经验的重要调节因素，一些最初的负面经验变得更加积极。确定代表从最初的负面过渡到更积极的过渡经验的转折点，可能有助于在培训的不同阶段调节学习和绩效的期望。
培训中的挑战要么可以促进发展，积极促进专业身份形成和临床能力，要么会阻碍学习，并可能导致从培训计划中倦怠和流失。这些发现将有助于未来研究确定过渡积极和负面经验的预测因素，并可能加强现有的和新兴的全科医生培训计划。这些发现可推广到其他基于社区的专科培训计划。
