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英国初级医生离开临床实践转而从事医学教育工作的转型经历:一项定性研究。

Transition experiences of UK junior doctors who leave clinical practice to pursue careers in medical education: a qualitative study.

作者信息

Coldicutt Olivia, Owen Katherine

机构信息

Medical Education, South Warwickshire University NHS Foundation Trust, Warwick, UK

Division of Health Sciences, Warwick Medical School, Coventry, UK.

出版信息

BMJ Open. 2024 Dec 10;14(12):e088615. doi: 10.1136/bmjopen-2024-088615.

Abstract

OBJECTIVES

The increasing complexity and scale of medical education in the UK demands increasing numbers of medical educators. A small proportion of educators are qualified doctors, but did not reach completion of clinical training (CCT) to become consultants or general practitioners before pursuing a career exclusively in education. This study aimed to (1) explore the experiences of medical educators who left clinical practice as junior doctors and (2) identify the barriers to professional identity formation in this group.

DESIGN

In this constructivist qualitative study, semi-structured interviews were conducted with medical educators. Audio data was recorded, transcribed and iteratively interpreted through the lens of reflexive thematic analysis.

SETTING AND PARTICIPANTS

Nine UK-based educators were recruited using purposive and snowball sampling. Participants self-identified as medical educators who have experience of the transition from working as junior clinicians to holding positions exclusively in medical education. Participants had not completed clinical training before transitioning into medical education.

RESULTS

Three broad themes were identified: (1) push factors away from clinical medicine; (2) pull factors towards medical education; (3) navigating professional identity formation as an educator. Educators reported that medical education offered positives such as improved work-life balance, professional development opportunities and a sense of being more 'upstream' in the world of education. Significant barriers to successful transition were reported, including: a lack of guidance; low respect for medical education by the wider medical profession; and disparity between the educational opportunities afforded to consultant colleagues compared with educators who left medicine before CCT.

CONCLUSIONS

Educators who leave clinical medicine before CCT perceive themselves as being disadvantaged in their education careers. This study highlights that more could be done to tackle stigmatising perceptions of a medical education career and present medical education as a viable option to junior doctors.

摘要

目标

英国医学教育的复杂性和规模不断增加,这就需要越来越多的医学教育工作者。一小部分教育工作者是合格的医生,但在专门从事教育事业之前,他们没有完成临床培训(CCT)以成为顾问医生或全科医生。本研究旨在:(1)探索作为初级医生离开临床实践的医学教育工作者的经历;(2)确定这一群体中职业身份形成的障碍。

设计

在这项建构主义定性研究中,对医学教育工作者进行了半结构化访谈。音频数据被记录、转录,并通过反思性主题分析的视角进行反复解读。

背景与参与者

采用目的抽样和滚雪球抽样的方法招募了9名英国的教育工作者。参与者自我认定为有从初级临床医生过渡到专门从事医学教育工作经历的医学教育工作者。参与者在转入医学教育之前没有完成临床培训。

结果

确定了三个广泛的主题:(1)远离临床医学的推动因素;(2)转向医学教育的拉动因素;(3)作为教育工作者塑造职业身份。教育工作者报告称,医学教育带来了一些积极方面,如改善工作与生活的平衡、职业发展机会以及在教育领域更具“上游”感。报告了成功过渡的重大障碍,包括:缺乏指导;广大医学专业人士对医学教育的尊重度低;与在完成CCT之前离开医学的教育工作者相比,顾问同事所获得的教育机会存在差异。

结论

在完成CCT之前离开临床医学的教育工作者认为自己在教育职业生涯中处于不利地位。本研究强调,在消除对医学教育职业的污名化看法以及向初级医生展示医学教育是一个可行选择方面,还有更多工作可做。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/feaf/11647326/d8977d031ec4/bmjopen-14-12-g001.jpg

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