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Qualitative research using realist evaluation to explain preparedness for doctors' memorable 'firsts'
Janet Lefroy1, Sarah Yardley1, Ruth Kinston1
1School of Medicine, Keele University, Keele, UK.
Medical Education
|July 27, 2017
Summary
Newly qualified doctors face a significant transition in responsibility, with full preparedness for initial tasks being unachievable. Support from colleagues and opportunities for rehearsal are key to building confidence during this critical period.
Area of Science:
- Medical Education
- Professional Development
- Healthcare Transition
Background:
- Patient safety necessitates competent doctors from day one.
- Medical students and new doctors report variable preparedness for practice.
Purpose of the Study:
- To identify factors and mechanisms influencing trainee readiness for initial tasks.
- To understand the causal chains leading to capability in new doctors.
Main Methods:
- A realist evaluation approach analyzed three transition stages: anticipation, lived experience, and reflection.
- Data collection included logbooks, audio diaries, interviews, and focus groups with medical students and postgraduate doctors.
- Analysis focused on 'first experiences' during the student-to-doctor transition.
Main Results:
- Preparedness varied, with some 'firsts' anticipated and others arising from the significant increase in responsibility.
- Opportunities for rehearsal and student responsibility improved preparation.
- Colleague support was crucial during the transition phase, fostering self-efficacy.
Conclusions:
- Total preparedness for the doctor's role transition is not fully achievable due to a step change in responsibility.
- The transition is a rite of passage, marked by independent decision-making.
- This study elucidates the mechanisms underlying preparedness for initial experiences in newly qualified doctors.
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