Brown Steven T R, Rothwell Charlotte, Manoharan Deepika, Burford Bryan, Vance Gillian
School of Medical Education, Newcastle University, Newcastle-upon-Tyne, UK.
Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, UK.
BMC Med Educ. 2025 Jul 1;25(1):987. doi: 10.1186/s12909-025-07484-1.
Patients with a chronic physical disease accompanied by other disease types or biopsychosocial factors- multiple long-term conditions (MLTC)- represent a major and growing clinical challenge. 17% of the population of England are forecast to fit this definition by 2035. The aim of this study was to understand and explore desirable MLTC-related learning outcomes identified by newly graduated doctors in the UK.
Focus groups were conducted across sites at two NHS trusts in Northern England with doctors in their second postgraduate year (Foundation Year 2 (FY2)). An iterative thematic analysis was applied to transcripts to identify and organise key themes.
Twenty-six participants across three focus groups reported their experience in primary and secondary care placements. The two overarching themes identified were: 1) 'Practice needs' for managing patients with MLTC. 2) 'Education needs' including limitations in undergraduate curricula. FY2s emphasised the concepts of uncertainty and complexity in practice, the variability of undergraduate learning experiences and gaps left by single-disease models of learning. Senior clinicians were highlighted as being key sources of support who modify learning experiences.
Newly qualified doctors find MLTC care challenging and feel ill-prepared to manage patients on entering the medical workforce. Suggested improvements for undergraduate curricula include enhancing interprofessional methods of learning and ensuring consistency of exposure to, and focus on, MLTC patient-related complexity across undergraduate placements and curricula.
Clinical Trial Number: Not applicable.
患有慢性身体疾病并伴有其他疾病类型或生物心理社会因素的患者——即多重长期病症（MLTC）——是一项重大且日益严峻的临床挑战。预计到2035年，英格兰17%的人口将符合这一定义。本研究的目的是了解和探索英国新毕业医生确定的与MLTC相关的理想学习成果。
在英格兰北部的两个国民保健服务信托机构的不同地点，对处于研究生第二年（基础年2（FY2））的医生进行了焦点小组访谈。对访谈记录进行了迭代主题分析，以识别和组织关键主题。
三个焦点小组的26名参与者报告了他们在初级和二级医疗护理实习中的经历。确定的两个总体主题是：1）管理MLTC患者的“实践需求”。2）“教育需求”，包括本科课程的局限性。FY2医生强调了实践中的不确定性和复杂性概念、本科学习经历的差异性以及单病种学习模式留下的空白。资深临床医生被视为能够改变学习经历的关键支持来源。
新获得资格的医生发现MLTC护理具有挑战性，并且在进入医疗行业时感觉没有做好管理患者的准备。对本科课程的建议改进包括加强跨专业学习方法，并确保在本科实习和课程中接触MLTC患者相关复杂性并对其予以关注的一致性。
临床试验编号：不适用。
