New graduate doctors' preparedness for practice

A multistakeholder, multicentre narrative study

Lynn V Monrouxe, Alison Bullock, Gerard Gormley, Kathrin Kaufhold, Narcie Kelly, Camille Emilie Roberts, Karen Mattick, Charlotte Rees

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objective While previous studies have begun to explore newly graduated junior doctors’ preparedness for practice, findings are largely based on simplistic survey data or perceptions of newly graduated junior doctors and their clinical supervisors alone. This study explores, in a deeper manner, multiple stakeholders’ conceptualisations of what it means to be prepared for practice and their perceptions about newly graduated junior doctors’ preparedness (or unpreparedness) using innovative qualitative methods.

Design A multistakeholder, multicentre qualitative study including narrative interviews and longitudinal audio diaries.

Setting Four UK settings: England, Northern Ireland, Scotland and Wales.

Participants Eight stakeholder groups comprising n=185 participants engaged in 101 narrative interviews (27 group and 84 individual). Twenty-six junior doctors in their first year postgraduation also provided audio diaries over a 3-month period.

Results We identified 2186 narratives across all participants (506 classified as ‘prepared’, 663 as ‘unprepared’, 951 as ‘general’). Seven themes were identified; this paper focuses on two themes pertinent to our research questions: (1) explicit conceptualisations of preparedness for practice; and (2) newly graduated junior doctors’ preparedness for the General Medical Council’s (GMC) outcomes for graduates. Stakeholders’ conceptualisations of preparedness for practice included short-term (hitting the ground running) and long-term preparedness, alongside being prepared for practical and emotional aspects. Stakeholders’ perceptions of medical graduates’ preparedness for practice varied across different GMC outcomes for graduates (eg, Doctor as Scholar and Scientist, as Practitioner, as Professional) and across stakeholders (eg, newly graduated doctors sometimes perceived themselves as prepared but others did not).

Conclusion Our narrative findings highlight the complexities and nuances surrounding new medical graduates’ preparedness for practice. We encourage stakeholders to develop a shared understanding (and realistic expectations) of new medical graduates’ preparedness. We invite medical school leaders to increase the proportion of time that medical students spend participating meaningfully in multiprofessional teams during workplace learning.
Original languageEnglish
Article number023146
Number of pages15
JournalBMJ Open
Volume8
Issue number8
DOIs
Publication statusPublished - 29 Aug 2018

Cite this

Monrouxe, L. V., Bullock, A., Gormley, G., Kaufhold, K., Kelly, N., Roberts, C. E., ... Rees, C. (2018). New graduate doctors' preparedness for practice: A multistakeholder, multicentre narrative study. BMJ Open, 8(8), [023146]. https://doi.org/10.1136/bmjopen-2018-023146
Monrouxe, Lynn V ; Bullock, Alison ; Gormley, Gerard ; Kaufhold, Kathrin ; Kelly, Narcie ; Roberts, Camille Emilie ; Mattick, Karen ; Rees, Charlotte. / New graduate doctors' preparedness for practice : A multistakeholder, multicentre narrative study. In: BMJ Open. 2018 ; Vol. 8, No. 8.
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abstract = "Objective While previous studies have begun to explore newly graduated junior doctors’ preparedness for practice, findings are largely based on simplistic survey data or perceptions of newly graduated junior doctors and their clinical supervisors alone. This study explores, in a deeper manner, multiple stakeholders’ conceptualisations of what it means to be prepared for practice and their perceptions about newly graduated junior doctors’ preparedness (or unpreparedness) using innovative qualitative methods.Design A multistakeholder, multicentre qualitative study including narrative interviews and longitudinal audio diaries.Setting Four UK settings: England, Northern Ireland, Scotland and Wales.Participants Eight stakeholder groups comprising n=185 participants engaged in 101 narrative interviews (27 group and 84 individual). Twenty-six junior doctors in their first year postgraduation also provided audio diaries over a 3-month period.Results We identified 2186 narratives across all participants (506 classified as ‘prepared’, 663 as ‘unprepared’, 951 as ‘general’). Seven themes were identified; this paper focuses on two themes pertinent to our research questions: (1) explicit conceptualisations of preparedness for practice; and (2) newly graduated junior doctors’ preparedness for the General Medical Council’s (GMC) outcomes for graduates. Stakeholders’ conceptualisations of preparedness for practice included short-term (hitting the ground running) and long-term preparedness, alongside being prepared for practical and emotional aspects. Stakeholders’ perceptions of medical graduates’ preparedness for practice varied across different GMC outcomes for graduates (eg, Doctor as Scholar and Scientist, as Practitioner, as Professional) and across stakeholders (eg, newly graduated doctors sometimes perceived themselves as prepared but others did not).Conclusion Our narrative findings highlight the complexities and nuances surrounding new medical graduates’ preparedness for practice. We encourage stakeholders to develop a shared understanding (and realistic expectations) of new medical graduates’ preparedness. We invite medical school leaders to increase the proportion of time that medical students spend participating meaningfully in multiprofessional teams during workplace learning.",
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Monrouxe, LV, Bullock, A, Gormley, G, Kaufhold, K, Kelly, N, Roberts, CE, Mattick, K & Rees, C 2018, 'New graduate doctors' preparedness for practice: A multistakeholder, multicentre narrative study', BMJ Open, vol. 8, no. 8, 023146. https://doi.org/10.1136/bmjopen-2018-023146

New graduate doctors' preparedness for practice : A multistakeholder, multicentre narrative study. / Monrouxe, Lynn V; Bullock, Alison; Gormley, Gerard; Kaufhold, Kathrin; Kelly, Narcie; Roberts, Camille Emilie; Mattick, Karen; Rees, Charlotte.

In: BMJ Open, Vol. 8, No. 8, 023146, 29.08.2018.

Research output: Contribution to journalArticleResearchpeer-review

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N2 - Objective While previous studies have begun to explore newly graduated junior doctors’ preparedness for practice, findings are largely based on simplistic survey data or perceptions of newly graduated junior doctors and their clinical supervisors alone. This study explores, in a deeper manner, multiple stakeholders’ conceptualisations of what it means to be prepared for practice and their perceptions about newly graduated junior doctors’ preparedness (or unpreparedness) using innovative qualitative methods.Design A multistakeholder, multicentre qualitative study including narrative interviews and longitudinal audio diaries.Setting Four UK settings: England, Northern Ireland, Scotland and Wales.Participants Eight stakeholder groups comprising n=185 participants engaged in 101 narrative interviews (27 group and 84 individual). Twenty-six junior doctors in their first year postgraduation also provided audio diaries over a 3-month period.Results We identified 2186 narratives across all participants (506 classified as ‘prepared’, 663 as ‘unprepared’, 951 as ‘general’). Seven themes were identified; this paper focuses on two themes pertinent to our research questions: (1) explicit conceptualisations of preparedness for practice; and (2) newly graduated junior doctors’ preparedness for the General Medical Council’s (GMC) outcomes for graduates. Stakeholders’ conceptualisations of preparedness for practice included short-term (hitting the ground running) and long-term preparedness, alongside being prepared for practical and emotional aspects. Stakeholders’ perceptions of medical graduates’ preparedness for practice varied across different GMC outcomes for graduates (eg, Doctor as Scholar and Scientist, as Practitioner, as Professional) and across stakeholders (eg, newly graduated doctors sometimes perceived themselves as prepared but others did not).Conclusion Our narrative findings highlight the complexities and nuances surrounding new medical graduates’ preparedness for practice. We encourage stakeholders to develop a shared understanding (and realistic expectations) of new medical graduates’ preparedness. We invite medical school leaders to increase the proportion of time that medical students spend participating meaningfully in multiprofessional teams during workplace learning.

AB - Objective While previous studies have begun to explore newly graduated junior doctors’ preparedness for practice, findings are largely based on simplistic survey data or perceptions of newly graduated junior doctors and their clinical supervisors alone. This study explores, in a deeper manner, multiple stakeholders’ conceptualisations of what it means to be prepared for practice and their perceptions about newly graduated junior doctors’ preparedness (or unpreparedness) using innovative qualitative methods.Design A multistakeholder, multicentre qualitative study including narrative interviews and longitudinal audio diaries.Setting Four UK settings: England, Northern Ireland, Scotland and Wales.Participants Eight stakeholder groups comprising n=185 participants engaged in 101 narrative interviews (27 group and 84 individual). Twenty-six junior doctors in their first year postgraduation also provided audio diaries over a 3-month period.Results We identified 2186 narratives across all participants (506 classified as ‘prepared’, 663 as ‘unprepared’, 951 as ‘general’). Seven themes were identified; this paper focuses on two themes pertinent to our research questions: (1) explicit conceptualisations of preparedness for practice; and (2) newly graduated junior doctors’ preparedness for the General Medical Council’s (GMC) outcomes for graduates. Stakeholders’ conceptualisations of preparedness for practice included short-term (hitting the ground running) and long-term preparedness, alongside being prepared for practical and emotional aspects. Stakeholders’ perceptions of medical graduates’ preparedness for practice varied across different GMC outcomes for graduates (eg, Doctor as Scholar and Scientist, as Practitioner, as Professional) and across stakeholders (eg, newly graduated doctors sometimes perceived themselves as prepared but others did not).Conclusion Our narrative findings highlight the complexities and nuances surrounding new medical graduates’ preparedness for practice. We encourage stakeholders to develop a shared understanding (and realistic expectations) of new medical graduates’ preparedness. We invite medical school leaders to increase the proportion of time that medical students spend participating meaningfully in multiprofessional teams during workplace learning.

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Monrouxe LV, Bullock A, Gormley G, Kaufhold K, Kelly N, Roberts CE et al. New graduate doctors' preparedness for practice: A multistakeholder, multicentre narrative study. BMJ Open. 2018 Aug 29;8(8). 023146. https://doi.org/10.1136/bmjopen-2018-023146