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From Learner to Provider: Navigating Role Tensions in Postgraduate Medical Training Through Activity Theory.
Sin-Yee Patty Kwong1,2, Shiuan-Ruey Yu1,2, Kuo-Chen Liao3
1Chang-Gung Medical Education Research Centre, Chang Gung Memorial Hospital, Taiwan.
Perspectives on Medical Education
|February 17, 2025
Summary
Postgraduate year (PGY) interns face role conflicts between learning and practicing medicine, leading to challenges like reality shock and incompetence. Targeted support is crucial for their professional development and well-being.
Area of Science:
- Medical Education
- Physician Training
- Qualitative Research
Background:
- The transition from medical school to residency presents significant challenges for new physicians.
- Understanding the experiences of postgraduate year (PGY) interns is vital for developing effective support systems.
Purpose of the Study:
- To explore the role conflicts and contradictions experienced by PGY interns.
- To identify factors influencing PGYs' professional growth and well-being during their internship.
Main Methods:
- A qualitative, longitudinal study involving ten PGY interns from August 2021 to July 2023.
- Biannual audio diaries with open-ended questions were used to capture participant experiences.
- Activity Theory guided the data analysis, focusing on role conflicts and contradictions.
Main Results:
- PGY interns frequently experienced role conflicts between their roles as learners and healthcare providers.
- Discrepancies in objectives between PGYs and experienced physicians intensified these conflicts.
- Common outcomes included reality shock, decreased confidence, feelings of incompetence, heavy workloads, and exhaustion.
Conclusions:
- Activity Theory provides a framework for understanding the challenges faced by PGY interns.
- Targeted interventions addressing tools, rules, and division of labor are needed to improve PGY training.
- Tailored support is essential to help PGYs navigate the transition into clinical practice and enhance their well-being.
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