“A steep learning curve”: junior doctor perspectives on the transition from medical student to the health-care workplace

Sturman, Nancy, Tan, Zachary and Turner, Jane (2017) “A steep learning curve”: junior doctor perspectives on the transition from medical student to the health-care workplace. BMC Medical Education, 17 92: 92-92. doi:10.1186/s12909-017-0931-2


Author Sturman, Nancy
Tan, Zachary
Turner, Jane
Title “A steep learning curve”: junior doctor perspectives on the transition from medical student to the health-care workplace
Journal name BMC Medical Education   Check publisher's open access policy
ISSN 1472-6920
Publication date 2017-05-26
Year available 2017
Sub-type Article (original research)
DOI 10.1186/s12909-017-0931-2
Open Access Status DOI
Volume 17
Issue 92
Start page 92
End page 92
Total pages 7
Place of publication London, United Kingdom
Publisher BioMed Central
Language eng
Subject 2700 Medicine
3304 Education
Abstract The transition from medical student to hospital-based first year junior doctor (termed "intern" in Australia) is known to be challenging, and recent changes in clinical learning environments may reduce graduate preparedness for the intern workplace. Although manageable challenges and transitions are a stimulus to learning, levels of burnout in junior medical colleagues are concerning. In order to prepare and support medical graduates, educators need to understand contemporary junior doctor perspectives on this transition.
Formatted abstract
Background
The transition from medical student to hospital-based first year junior doctor (termed “intern” in Australia) is known to be challenging, and recent changes in clinical learning environments may reduce graduate preparedness for the intern workplace. Although manageable challenges and transitions are a stimulus to learning, levels of burnout in junior medical colleagues are concerning. In order to prepare and support medical graduates, educators need to understand contemporary junior doctor perspectives on this transition.

Methods
Final-year University of Queensland medical students recruited junior doctors working in diverse hospital settings, and videorecorded individual semi-structured interviews about their transition from medical student to working as a junior doctor. Two clinical academics (NS and JT) and an intern (ZT) independently conducted a descriptive analysis of interview transcripts, and identified preliminary emerging concepts and themes, before reaching agreement by consensus on the major overarching themes.

Results
Three key themes emerged from the analysis of 15 interviews: internship as a “steep learning curve”; relationships and team; and seeking help. Participants described the intern transition as physically, mentally and emotionally exhausting. They learned to manage long days, administrative and clinical tasks, frequent interruptions and time pressures; identify priorities; deal with criticism without compromising key relationships; communicate succinctly; understand team roles (including their own status within hospital hierarchies); and negotiate conflict. Participants reported a drop in self-confidence, and difficulty maintaining self-care and social relationships. Although participants emphasised the importance of escalating concerns and seeking help to manage patients, they appeared more reluctant to seek help for personal issues and reported a number of barriers to doing so.

Conclusion
Findings may assist educators in refining their intern preparation and intern training curricula, and ensuring that medical school and intern preparation priorities are not seen as competing. Insights from non-medical disciplines into the organisational and relational challenges facing junior doctors and their health-care teams may enhance inter-professional learning opportunities. Workplace support and teaching, especially from junior colleagues, is highly valued during the demanding intern transition.
Q-Index Code C1
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
School of Clinical Medicine Publications
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Created: Wed, 07 Jun 2017, 15:56:18 EST by Dr Nancy Sturman on behalf of Primary Care Clinical Unit