"一切新事物都在同时发生":对早期职业妇产科医生独立执业准备情况的定性研究。

Canadian medical education journal Pub Date : 2024-07-12 eCollection Date: 2024-07-01 DOI:10.36834/cmej.77329
Nicole Wiebe, Andrea Hunt, Taryn Taylor
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引用次数: 0

摘要

背景:从住院医师培训过渡到执业过程中,诉讼、职业倦怠和压力的风险与日俱增。然而,除了确保临床能力之外,我们对如何让毕业生为独立执业做好充分准备知之甚少。因此,我们探讨了应届妇产科毕业生向独立执业过渡(TTP)的经历,以了解他们在执业准备方面的潜在差距:我们采用建构主义基础理论,对过去五年内从加拿大九个住院医师培训项目毕业的 20 名妇产科医生进行了半结构化访谈。通过反复的数据收集和分析,我们提出了一些关键主题:结果:五个关键主题涵盖了参与者在整个过渡时期所经历的不同实践差距。这些实践差距可归纳为五个能力领域:提供临床护理,如处理不熟悉的低风险门诊病例;管理后勤,如分流转诊;管理行政,如聘用或解雇辅助人员;恢复人格,如设定工作与家庭之间的界限;承担最终责任,如处理患者投诉。研究发现,一些缓解因素会扩大或缩小新毕业生的实习差距。学员们普遍认为,有些实践差距不可能在培训期间解决:结论:现有的实践差距是多方面的,也许在住院实习期间无法切实解决。相反,TTP 指导和培训机会必须延伸到实习期之后,以确保新毕业生具备独立执业的全面能力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
"Everything new is happening all at once": a qualitative study of early career obstetrician and gynaecologists' preparedness for independent practice.

Background: The transition from residency training into practice is associated with increasing risks of litigation, burnout, and stress. Yet, we know very little about how best to prepare graduates for the full scope of independent practice, beyond ensuring clinical competence. Thus, we explored the transition to independent practice (TTP) experiences of recent Obstetrics and Gynaecology graduates to understand potential gaps in their perceived readiness for practice.

Methods: Using constructivist grounded theory, we conducted semi-structured interviews with 20 Obstetricians/Gynaecologists who graduated from nine Canadian residency programs within the last five years. Iterative data collection and analysis led to the development of key themes.

Results: Five key themes encompassed different practice gaps experienced by participants throughout their transition. These practice gaps fit into five competency domains: providing clinical care, such as managing unfamiliar low-risk ambulatory presentations; navigating logistics, such as triaging referrals; managing administration, such as hiring or firing support staff; reclaiming personhood, such as boundary-setting between work and home; and bearing ultimate responsibility, such as navigating patient complaints. Mitigating factors were found to widen or narrow the extent to which new graduates experienced a practice gap. There was a shared sense among participants that some practice gaps were impossible to resolve during training.

Conclusions: Existing practice gaps are multi-dimensional and perhaps not realistically addressed during residency. Instead, TTP mentorship and training opportunities must extend beyond residency to ensure that new graduates are equipped for the full breadth of independent practice.

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