Carlsson Yvonne, Olow Filip, Bergman Stefan, Nilsdotter Anna, Liljedahl Matilda
School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Accident & Emergency Medicine, NU Hospital Group, Trollhättan, Sweden.
Adv Health Sci Educ Theory Pract. 2025 Mar 13. doi: 10.1007/s10459-025-10424-9.
The transition from being a medical student to working as a doctor is a pivotal phase, often marked by challenges in balancing learning with the demands of clinical practice. Despite extensive research on the struggles faced by junior doctors, there remains a gap in understanding how other key stakeholders perceive this transition and how it can be viewed as more than just a struggle. In this phenomenographic study, we used the Swedish medical internship as a proxy for the transition and explored internship programme directors' (PDs) perceptions of the medical internship from a developmental point of view. A phenomenographic approach was chosen to capture the variation in how PDs conceptualise the meaning of the internship, offering a more nuanced understanding of the transition and its implications for educational practice. Interviews with twelve PDs gave rise to three perceptions: the internship as an education, as working as a doctor, and as a space for learning through work. These views highlighted the transition not merely as a preparatory phase but as a dynamic process in which learning and clinical work were intertwined. Our findings suggest that instead of focusing solely on better preparing students for work, empowering junior doctors to learn through work-supported by structured guidance-can turn this challenging period into an opportunity for professional and personal growth. This study offers a novel contribution by shedding light on the role of PDs in shaping the transition to clinical work and emphasising the need to view it as a learning-centred, reflective experience.
从医学生转变为医生是一个关键阶段，其特点往往是在平衡学习与临床实践需求方面存在挑战。尽管对初级医生所面临的困难进行了广泛研究，但在理解其他关键利益相关者如何看待这一转变以及如何将其不仅仅视为一场挣扎方面，仍存在差距。在这项现象学研究中，我们将瑞典医学实习作为这一转变的代表，并从发展的角度探讨了实习项目主任（PDs）对医学实习的看法。我们选择了一种现象学方法来捕捉PDs对实习意义的概念化方式的差异，从而更细致入微地理解这一转变及其对教育实践的影响。对12名PDs的访谈产生了三种看法：实习是一种教育、是作为医生开展工作以及是一个通过工作进行学习的空间。这些观点强调了这一转变不仅仅是一个准备阶段，而是一个学习与临床工作相互交织的动态过程。我们的研究结果表明，与其仅仅专注于让学生更好地为工作做准备，不如在结构化指导的支持下，赋予初级医生通过工作学习的能力，这样可以将这个具有挑战性的时期转变为专业和个人成长的机会。这项研究通过揭示PDs在塑造向临床工作转变过程中的作用，并强调将其视为以学习为中心的反思性经历的必要性，做出了新颖的贡献。
