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Preparedness is not enough: understanding transitions as critically intensive learning periods
Sue Kilminster1, Miriam Zukas, Naomi Quinton
1Leeds Institute of Medical Education, Faculty of Medicine and Health, University of Leeds, Leeds, UK. s.kilminster@leeds.ac.uk
Medical Education
|September 16, 2011
Summary
Doctor transitions significantly impact medical performance and patient safety. Understanding these critical learning periods is key to improving trainee performance and healthcare outcomes.
Area of Science:
- Medical Education
- Patient Safety
- Healthcare Management
Background:
- Doctor transitions, akin to high-risk professions, are under-researched regarding patient safety implications.
- Previous studies highlight risks associated with transitions in fields like aviation, but not comprehensively in medicine.
Purpose of the Study:
- To investigate the effects of professional transitions on doctors' performance.
- To analyze the inter-relationships between doctors and their work settings during transitions.
Main Methods:
- A collective case study design focusing on foundation year and specialist trainee doctors.
- Data collection through interviews, observations, and desk-based research across four levels: regulatory, employer, team, and individual.
Main Results:
- Transitions are regulated but lack systematic monitoring, with practice heavily influenced by context over formal frameworks.
- Local learning environments critically impact trainee performance.
- While protocols improve performance, unregulated aspects like rotas and induction impede it.
Conclusions:
- Doctor transitions should be viewed as critically intensive learning periods (CILPs).
- Institutional learning cultures that acknowledge transitions as CILPs enhance new doctor performance.
- Findings inform practice, policy, regulation, and future research on medical transitions.
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