Synnott David, Cavallari Sarah, Synnott Kevin, Coakley Niamh
School of Medicine, University College Cork, Cork, Ireland.
Tracer Tech, London, UK.
Clin Teach. 2025 Apr;22(2):e70035. doi: 10.1111/tct.70035.
The transition from medical student to doctor is a significantly stressful event with a perceived lack of preparedness. A comprehensive exploration of the facilitators and barriers to preparedness for out-of-hours specifically, such as night duty, is lacking. This study aims to investigate the perspectives of newly qualified Irish doctors (interns) regarding their readiness for out-of-hours work, the levels of support available and the influence of their medical education on readiness.
A survey using both quantitative and qualitative data was developed and distributed amongst 145 interns in one Irish regional 'network' using nonprobability sampling. Quantitative data were analysed using nonparametric methods of Likert scale responses. Qualitative data underwent thematic analysis using Braun and Clarke's approach.
Seventy-seven respondents met inclusion criteria. Of participants, 88.3% disagreed with feeling prepared for out-of-hours, a sentiment corroborated by qualitative expressions of fear and apprehension. Themes emerged regarding general preparedness, support, and the hidden curriculum. Seeking support presented challenges, often met with resistance. Isolation and post-call anxiety were recurrent sentiments. Participants believed medical education had inadequately prepared them, emphasising theoretical knowledge at the expense of practical skills for real-world scenarios.
This study highlights the anxiety and isolation experienced by new doctors, underscoring a pervasive sense of unpreparedness, inadequate support structures and a disconnect between medical education and the practical demands of out-of-hours clinical work. These findings support current literature and emphasise the need for enhanced training, emotional support and better alignment between education and clinical realities for out of hours.
从医学生转变为医生是一个压力巨大的事件，且普遍感觉准备不足。目前缺乏对诸如夜间值班等非工作时间准备工作的促进因素和障碍的全面探索。本研究旨在调查新获得资格的爱尔兰医生（实习医生）对非工作时间工作准备情况的看法、可获得的支持水平以及医学教育对准备情况的影响。
开发了一项同时使用定量和定性数据的调查，并通过非概率抽样在爱尔兰一个地区“网络”的145名实习医生中进行了分发。使用李克特量表回答的非参数方法对定量数据进行分析。定性数据采用布劳恩和克拉克的方法进行主题分析。
77名受访者符合纳入标准。在参与者中，88.3%不同意自己为非工作时间做好了准备，恐惧和担忧的定性表达也证实了这种情绪。出现了关于总体准备、支持和隐性课程的主题。寻求支持存在挑战，往往遭到抵制。孤独感和下班后焦虑情绪反复出现。参与者认为医学教育没有让他们做好充分准备，过分强调理论知识而牺牲了实际场景中的实践技能。
本研究突出了新医生所经历的焦虑和孤独感，强调了普遍存在的准备不足感、支持结构不完善以及医学教育与非工作时间临床工作实际需求之间的脱节。这些发现支持了当前的文献，并强调需要加强培训、提供情感支持，以及使非工作时间教育与临床实际更好地结合。
