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Participation and progression: new medical graduates entering professional practice

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Abstract

The first year of practice after medical school is considered to be an essential part of becoming a medical practitioner in Australia. Previous qualitative investigations have investigated a number of significant aspects of this early stage of professional development. This qualitative study explores experiences and developing professional identities during internship. Thirty interns and six intern supervisors were interviewed from three different Australian states. Grounded theory techniques were used to develop three key themes: internship-as-participation, internship-as-progression, and conflicts, parallels, disturbances and outliers. Key findings were: the important balance between support from colleagues and development through taking independent responsibility; and the strength of the view of internship as part of a ‘natural progression’, an inevitable evolution through the stages of medical training.

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References

  • Beard, J., Strachan, A., & Davies, H. (2005). Developing an education and assessment framework for the foundation programme. Medical Education, 39(8), 841–851.

    Article  Google Scholar 

  • Benner, P. (2004). Using the Dreyfus model of skill acquisition to describe and interpret skill acquisition and clinical judgment in nursing practice and education. Bulletin of Science, Technology & Society, 24(3), 188–199.

    Article  Google Scholar 

  • Bleakley, A. (2002). Pre-registration house officers and ward based learning: A ‘new apprenticeship’ model. Medical Education, 36, 9–15.

    Article  Google Scholar 

  • Brennan, N., Corrigan, O., Allard, J., Archer, J., Barnes, R., et al. (2010). The transition from medical student to junior doctor: Today’s experiences of tomorrow’s doctors. Medical Education, 44(5), 449–458.

    Article  Google Scholar 

  • Engestrom, Y. (2009). Expansive learning: Toward an activity-theoretical reconceptualization. In K. Illeris (Ed.), Contemporary theories of learning (pp. 53–73). Oxon: Routledge.

    Google Scholar 

  • Fuller, A., Hodkinson, H., Hodkinson, P., & Unwin, L. (2005). Learning as peripheral participation in communities of practice: A reassessment of key concepts in workplace learning. British Educational Research Journal, 31(1), 49–68.

    Article  Google Scholar 

  • Graham, I. S., Gleason, A. J., Keogh, G. W., Paltridge, D., Rogers, I. R., Walton, M., et al. (2007). Australian curriculum framework for junior doctors. Medical Journal of Australia, 186(7 Suppl), S14–S19.

    Google Scholar 

  • Iedema, R., Brownhill, S., Haines, M., Lancashire, B., Shaw, T., & Street, J. (2010). ‘Hands on, hands off’: A model of clinical supervision that recognises trainees’ need for support and independence. Australian Health Review, 34(3), 286–291.

    Article  Google Scholar 

  • Illing, J., Morrow, G., Kergon, C., Burford, B., Spencer, J., et al. (2008). How prepared are medical graduate to begin practice. Final report for the GMC education committee. London: GMC.

  • Lave, J., & Wenger, E. (1991). Situated learning: Legitimate peripheral participation. Cambridge: Cambridge University Press.

    Google Scholar 

  • Lawson, M., & Bearman, M. (2007a, released 2010). Summary report: Surveys, focus groups and interviews. Australian Medical Education Study. Commonwealth of Australia. http://www.deewr.gov.au/HigherEducation/Publications/HEReports/Documents/AMES-8.pdf.

  • Lawson, M., & Bearman, M. (2007b, released 2010). Focus group and interview: Medical students, recent medical graduates, employers and clinical trainers Australian Medical Education Study, Commonwealth of Australia. http://www.deewr.gov.au/HigherEducation/Publications/HEReports/Documents/AMES-6.pdf.

  • Lawson, M., Bearman, M., & Byrne, C. (2007a, released 2010). Survey report: Medical students, recent medical graduates, Employers and Clinical Trainer Australian Medical Education Study, Commonwealth of Australia. http://www.deewr.gov.au/HigherEducation/Publications/HEReports/Documents/AMES-4-5.pdf.

  • Lawson, M., Bearman, M., & Jones, A. (2007b, released 2010). Intern case study report: Interns and supervisors, Australian Medical Education Study, Commonwealth of Australia. http://www.deewr.gov.au/HigherEducation/Publications/HEReports/Documents/AMES-7.pdf.

  • Lempp, H., Cochrane, M., Seabrook, M., & Rees, J. (2004). Impact of educational preparation on medical students in transition from final year to PRHO year: A qualitative evaluation of final-year training following the introduction of a new Year 5 curriculum in a London medical school. Medical Teacher, 26(3), 276–278.

    Article  Google Scholar 

  • Lempp, H., Seabrook, M., Cochrane, M., & Rees, J. (2005). The transition from medical student to doctor: Perceptions of final year students and preregistration house officers related to expected learning outcomes. International Journal of Clinical Practice, 59(3), 324–329.

    Article  Google Scholar 

  • Monrouxe, L. V. (2009). Negotiating professional identities: Dominant and contesting narratives in medical students’ longitudinal audio diaries. Current Narratives, 1(2009), 41–59.

    Google Scholar 

  • Monrouxe, L. V. (2010). Identity, identification and medical education: Why should we care? Medical Education, 44(1), 40–49.

    Article  Google Scholar 

  • O’Neill, P., Jones, A., Willis, S. C., & McArdle, P. J. (2003). Does a new undergraduate curriculum based on tomorrow’s doctors prepare house officers better for their first post? A qualitative study of the views of pre-registration house officers using critical incidents. Medical Education, 37(12), 1100–1108.

    Article  Google Scholar 

  • Prince, K., Van de Wiel, M., Van der Vleuten, C., Boshuizen, H., & Scherpbier, A. (2004). Junior doctors’ opinions about the transition from medical school to clinical practice: A change of environment. Education for Health, 17(3), 323–331.

    Article  Google Scholar 

  • Sheehan, D., Wilkinson, T., & Billet, S. (2005). Intern’s participation and learning in clinical environments in a New Zealand hospital. Academic Medicine, 80(3), 302–308.

    Article  Google Scholar 

  • Strauss, A. L., & Corbin, J. (1998). Basics of qualitative research: Techniques and procedures for developing grounded theory (2nd ed.). Thousand Oaks: Sage Publications.

    Google Scholar 

  • Wenger, E. (1998). Communities of practice: Learning, meaning, and identity. Cambridge: Cambridge University Press.

    Google Scholar 

  • Wilkinson, T. J., & Harris, P. (2002). The transition out of medical school; a qualitative study of descriptions of borderline trainee interns. Medical Education, 36(5), 466–471.

    Article  Google Scholar 

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Acknowledgments

We would like to acknowledge the contribution of: Beverley Bird; Samantha Thomas and team; and Fiona Williams. We would also like to thank the Associate Editor and the three anonymous reviewers for their comments. The data in the study was collected for the Australian Medical Education Study, funded by Commonwealth of Australia.

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Correspondence to Margaret Bearman.

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Bearman, M., Lawson, M. & Jones, A. Participation and progression: new medical graduates entering professional practice. Adv in Health Sci Educ 16, 627–642 (2011). https://doi.org/10.1007/s10459-011-9284-5

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