When becoming a specialist, learning-through-service plays a significant role. The workplace affords good opportunities for learning, but the service-learning period may also impose stress on phycisians in specialization training. In medical work, social support has proved to be a very important factor in managing stress. Social support may afford advantages also for learning and professional identity building. However, little was known about how social support is perceived by doctors in specialization training. This study aimed to understand the perceptions of physicians in specialization training regarding social support communication in their workplace during their learning-through-service period. The study was conducted qualitatively by inductively analyzing the physicians’ descriptions of workplace communication. The dataset included 120 essays, 60 each from hospitals and primary healthcare centres. Physicians in specialization training explained the need of social support with the responsibilities and demands of their clinical work and the inability to control and manage their workloads. They perceived that social support works well for managing stress, but also for strengthening relational ties and one’s professional identity. A leader’s support was perceived as being effective, and both senior and junior colleagues were described as an important source of social support. Also co-workers, such as the individual nurse partner with whom one works, was mentioned as an important source of social support. The results of this study indicate that social support works at the relational and identity levels, which is due to the multi-functional nature of workplace communication. For example, consultation functions as situational problem-solving, but also the tone of social interaction is meaningful. Thus, strengthening one’s professional identity or collegial relationships requires further attention to workplace communication. Abbreviations PiST: Physician in specialization training
Special diets are consumed as a treatment for diseases such as food allergies, diabetes, lactose intolerance, and coeliac disease. Lifestyle-related diets, such as vegetarian, weight-reducing, sports, bodybuilding, and low-carbohydrate diets, can also be called special diets. The aim of this study was to examine the frequency of and reasons for special diet consumption as a therapeutic measure or as a lifestyle-related choice among 12-to 18-year-old Finns. Nationwide cross-sectional data were collected by mailed, self-administered questionnaires in 1999, 2001, 2007, and 2013.The number of respondents varied from 3535 to 8219, and response rates ranged from 38% to 76%. Consumption of special diets, both for therapeutic purposes and as a lifestyle-related choice, showed a significant increasing trend in 12-to 18-year-olds from 1999 to 2013 (p < .001). During the study period, the most frequently-reported single diets in adolescents were vegetarian and lactose intolerance diets. However, a fluctuation trend was observed in the consumption of different lifestyle-related diets. Further, a growing number of respondents, especially girls, reported simultaneous consumption of a combination of two or more therapeutic and/or lifestyle-related diets.The reason(s) for choosing a therapeutic diet seems to stay constant during the studied period. In contrast, a wide variety of reasons such as health, wellbeing, body weight, ethical, and ideological reasons, and the avoidance of some specific foods were given for the consumption of lifestylerelated diets. Our study results correspond well to the increased prevalence of common illnesses in Finland. Data also reveal the properties of special diet consumption among adolescents in the long run, and this highlights the need to further educate Finnish adolescents on nutrition literacy. K E Y W O R D Sadolescent, diet behavior, diet combinations, special diet
In Finland, the specialization programs in Medicine and Dentistry can be undertaken at all five university medical faculties in 50 specialization programs and in five programs for Dentistry. The specialist training requires 5 or 6 years (300–360 ECTS credits) of medical practice including 9 months of service in primary health care centers, theoretical substance specific education, management studies, and passing a national written exam. The renovation of the national curriculum for the specialization programs was implemented, first in 2008 and officially in August 2009, when theoretical multi-professional social, health management and leadership studies (10–30 ECTS credits) were added to the curriculum. According to European Credit Transfer and Accumulation System (ECTS), 1 ECTS credit (henceforth, simply “ECTS”) means 27–30 h of academic work1 National guidelines for the multi-professional leadership training include the basics of organizational management and leadership, the social and healthcare system, human resources (HR) management, leadership interaction and organizational communication, healthcare economy, legislation (HR) and data management. Each medical faculty has implemented management studies autonomously but according to national guidelines. This paper will describe how the compulsory management studies (10 ECTS) have been executed at the Universities of Tampere and Turku. In Tampere, the 10 ECTS management studies follow a flexible design of six academic modules. Versatile modern teaching methods such as technology-assisted and student orientated learning are used. Advanced supplementary management studies (20 ECTS) are also available. In Turku, the 10 ECTS studies consist of academic lectures, portfolio and project work. Attendees select contact studies (4–6 ECTS) from yearly available 20 ECTS and proceed at their own pace. Portfolio and project comprise 2–5 ECTS each. The renovation of medical specializing physicians' management and leadership education has been a successful reform. It has been observed that positive attitudes and interest toward management overall are increasing among younger doctors. In addition, management and leadership education will presumably facilitate medical doctors' work as managers also. Continuous development of medical doctors' management and leadership education for physicians and dentists is needed while the changing and complex healthcare environment requires both professional and leadership expertise.
Purpose A frame is an interpretive scheme of meanings that guide participants’ interpretations of social interaction and their actions in social situations (Goffman, 1974). By identifying early-career physicians’ identity and relationship frames, this study aims to produce information about socially constructed ways to interpret leadership communication in a medical context. Design/methodology/approach The data consist of essays written by young physicians (n = 225) during their specialization training and workplace learning period. The analysis was conducted applying constructive grounded theory. Findings Three identity and relationship frames were identified: the expertise frame, the collegial frame and the system frame. These frames arranged the meanings of being a physician in a leader-follower relationship differently. Originality/value The findings suggest that identity questions discussed recently in medical leadership studies can be partly answered with being aware of and understanding socially constructed and somewhat contradictory frames.
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