A study on transition shock among first-year residents in China: survey data based on latent profile analysis

This study aims to identify heterogeneous subgroups of first-year residents experiencing transition shock using latent profile analysis (LPA) and to explore the predictive effects of various dimensions of professional identity on different transition shock types.

A multi-center, cross-sectional design was employed. From September 2023 to August 2024, a total of 766 first-year residents were selected via cluster sampling from four national-level training bases in Hubei Province, China, for a cross-sectional survey. The survey was conducted using the revised Transition Shock Scale (Cronbach's α = 0.862) and the Professional Identity Scale (Cronbach's α = 0.879). Data analysis was performed using R software, involving latent profile analysis and multinomial logistic regression.

A total of 574 valid questionnaires were returned. Latent profile analysis identified three latent classes: a low psychological-sociocultural shock group (13.41%, n = 77), a high physical-knowledge/skill shock group (27.01%, n = 155), and a moderate transition shock group (59.58%, n = 342). When compared to the low psychological-sociocultural shock group, the various dimensions of professional identity exhibited a contradictory predictive effect for the high physical-knowledge/skill shock group. Specifically, higher scores in the dimensions of professional cognition (OR = 0.724, 95% CI = 0.639-0.820), professional commitment (OR = 0.791, 95% CI = 0.636-0.984), and professional expectation (OR = 0.725, 95% CI = 0.586-0.898) were associated with a greater likelihood of belonging to the low psychological-sociocultural shock group. Conversely, a higher score in professional values was associated with an increased risk of belonging to the high physical-knowledge/skill shock group (OR = 1.139, 95% CI = 1.014-1.279). Using the low psychological-sociocultural shock group as the reference, residents who were Master of Medicine (MM) degree candidates were significantly more likely to be classified into the high physical-knowledge/skill shock group (OR = 3.477, 95% CI = 1.707-7.086). When using the moderate transition shock group as the reference, the same MM degree candidates were less likely to belong to the low psychological-sociocultural shock group (OR = 0.447, 95% CI = 0.244-0.818).

Transition shock among first-year residents exhibits significant heterogeneity. These findings provide evidence for developing targeted intervention strategies. Higher levels of professional cognition, commitment, and expectation are associated with lower levels of transition shock. However, a strong sense of professional values is associated with higher transition shock, a relationship potentially mediated by an idealism-reality gap. It is recommended that tiered competency-building interventions should be implemented for the high physical-knowledge/skill shock group, and a dual-track support system should be designed for Master of Medicine degree candidates.