Preparedness for practice: The perceptions of medical graduates and clinical teams
Preparedness for practice: The perceptions of medical graduates and clinical teams
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DOI：
10.3109/0142159x.2012.643260
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发表时间：
2012-01-01
期刊：
影响因子：
4.7
通讯作者：
Illing, Jan
中科院分区：
文献类型：
--
作者：
Morrow, Gill;Johnson, Neil;Illing, Jan
背景：早期的研究表明，医学毕业生觉得没有准备好开始工作，这一点在不同的医学院有所不同。目的：检查来自英国不同医学院的毕业生对实习准备的看法的差异程度，并将他们的看法与临床团队成员的看法进行比较。方法：设计了一份匿名问卷，评估53个方面的准备情况，并对三所医学院的毕业生进行了测试：纽卡斯尔(基于系统的综合课程)、华威(研究生入学)和格拉斯哥(基于问题的学习)。结果：队列问卷的应答率为69%(479/698)。总体平均准备分数为3.5(满分为5分)，不同学校之间没有显著差异。在个别项目上，每个网站内的差异很大，但网站之间的差异较小。毕业生们对与病人和同事共事、病历记录和考试方面的准备最充分。他们觉得在填写火葬表、处方的某些方面、复杂的实际程序以及应用替代疗法和补充疗法以及国民保健制度的知识方面准备不足。总共完成了80份临床团队调查问卷，同样显示每个站点内的差异很大，但站点之间的差异较小。结论：新医生对实践的许多方面感到相对缺乏准备，他们的同事也有同样的看法。尽管医学院在准备方面有一些影响，但不同地点之间的差异更大。差异可能反映了所有学校共同的隐藏影响，国家课程指导的意想不到的后果，或者抽样研究生群体的共同特征。需要进一步的研究来确定原因。
Background: Earlier research indicated that medical graduates feel unprepared to start work, and that this varies with medical school.Aims: To examine the extent to which graduates from different UK medical schools differed in their perceptions of preparedness for practice, and compare their perceptions with those of clinical team members.Method: An anonymous questionnaire assessing perceptions of 53 aspects of preparedness was devised, and administered to the graduating cohorts of three medical schools: Newcastle (systems-based, integrated curriculum); Warwick (graduate-entry) and Glasgow (problem-based learning). In addition, a triangulating questionnaire was cascaded via ward managers to doctors, nurses and pharmacists who worked with new graduates in their first posts.Results: The response rate for the cohort questionnaire was 69% (479/698). The overall mean preparedness score was 3.5 (on a five-point scale), with no significant difference between schools. On individual items, there were large differences within each site, but smaller differences between sites. Graduates felt most prepared for aspects of working with patients and colleagues, history taking and examination. They felt least prepared for completing a cremation form, some aspects of prescribing, complex practical procedures and for applying knowledge of alternative and complementary therapies, and of the NHS. A total of 80 clinical team questionnaires were completed, similarly showing substantial variation within each site, but smaller differences between sites.Conclusions: New doctors feel relatively unprepared for a number of aspects of practice, a perception shared by their colleagues. Although medical school has some effect on preparedness, greater differences are common across sites. Differences may reflect hidden influences common to all the schools, unintended consequences of national curriculum guidance or common traits in the graduate populations sampled. Further research is needed to identify the causes.