Learning the house officer role: reflections on the value of shadowing a PRHO

Jones, Alison; Willis, Sarah; McArdle, Patricia; O’Neill, Paul

doi:10.1080/01421590600627011

Cited by 24 publications

(36 citation statements)

References 7 publications

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“…The importance of a pre-intern attachment in preparing medical graduates for their first postgraduate year has recently been demonstrated (Evans et al 2004;Lempp et al 2004;Jones et al 2006;Watmough et al 2006). This is the first study to do so in the context of a year long pre-internship.…”

Section: Discussionmentioning

confidence: 93%

“…Tomorrow's Doctor's (UK) recommends that students have 'opportunities to shadow the PRHO post that they take up when they graduate' (General Medical Council 1993). Early data from these interventions suggest that a short pre-intern placement provides opportunity for focused clinical apprenticeship not obtained in previous curricula (Lempp et al 2004;Jones et al 2006) and that this can improve feelings of preparedness amongst students (Jones et al 2006). A year long apprenticeship has been part of the New Zealand medical curriculum for over 30 years.…”

Section: Discussionmentioning

confidence: 99%

“…Familiarity with these 'bread and butter' aspects of the intern role reduces the anxiety associated with the transition, and improve confidence (Lempp et al 2004;Jones et al 2006).…”

Section: Discussionmentioning

confidence: 99%

“…Early medical education should be broad, preparing students for a lifetime of clinical practice. Nevertheless the undergraduate curriculum should align with the requirements of the early postgraduate years ( (Goldacre et al 2003;Jones et al 2006;Watmough et al 2006) resulted in the introduction of shadowing and pre-intern periods during the final year of medical school (Lempp et al 2004;Jones et al 2006;Watmough et al 2006). Tomorrow's Doctor's (UK) recommends that students have 'opportunities to shadow the PRHO post that they take up when they graduate' (General Medical Council 1993).…”

Section: Discussionmentioning

confidence: 99%

“…It can be stressful for the young doctor and there can be varying expectations from employers and supervisors on their capabilities (Goldacre et al 2003;Wall et al 2006;Cave et al 2007;Leeder 2007). It is important to align undergraduate with early postgraduate training to smooth this transition (General Medical Council 1993 Many medical schools have tried to ease the transition to internship by offering short periods of shadowing an intern (Jones et al 2006) or 'pre-internship' placements (Evans et al 2004; Lempp et al 2004), usually of 2-4 weeks duration ( Jones et al 2006). In contrast, New Zealand has had a transitional year within its undergraduate medical curriculum.…”

Section: Introductionmentioning

confidence: 99%

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Training the intern: The value of a pre-intern year in preparing students for practice

et al. 2009

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Aims: To evaluate the clinical and professional development that occurs during a New Zealand trainee intern year in preparation for the first house officer role. Methods: A quantitative questionnaire was distributed to all trainee interns (year 6) and year 5 medical students in New Zealand at the end of the 2007 academic year. This survey assessed self-reported competency and performance across clinical, professional and role development domains. Results: Response rate was 65% (457/702). Compared to year 5 students, trainee interns reported significantly greater competence and performance levels across all three domains. The greatest improvement occurred in the independent performance of procedural skills (trainee interns: 77%, year 5: 35%, p50.001) and clinical tasks (trainee interns: 94%, year 5: 56%, p50.001) and in the level of clinical responsibility taken ( p50.001). At the end of the trainee intern year, 92% of students felt prepared to be a junior doctor, versus only 53% at the end of their 5th year ( p50.0001). Conclusions:The trainee intern year is important in preparing graduates for the intern role. The year affords increased responsibility and practical experience, whilst retaining an educational focus, facilitating the move from competence towards performance. Preparedness for practice was substantially higher following the New Zealand trainee intern year than has been reported with other pre-intern placements.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

“…Familiarity with these 'bread and butter' aspects of the intern role reduces the anxiety associated with the transition, and improve confidence (Lempp et al 2004;Jones et al 2006).…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Training the intern: The value of a pre-intern year in preparing students for practice

et al. 2009

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Transitioning from university to postgraduate medical training: A narrative review of work readiness of medical graduates

Padley

Boyd

Jones

et al. 2021

Health Science Reports

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Context Work readiness is often described in terms of the clinical competence medical graduates bring to day 1 of internship. Despite being increasingly viewed as a key graduate outcome, work readiness has remained poorly defined. Objective This narrative review draws on the international literature to explore how different research methods provide differing insight into what constitutes work readiness of medical graduates. From this, we explored contributory factors and developed a conceptual framework to better understand work readiness. Methods Databases were searched using the terms including “ready,” “readiness,” “preparedness,” “medical graduates,” “intern,” and “junior doctor.” Information was summarized using a textual description template that included information on study setting, participants, methodologies, limitations, and key result areas (including measures/themes and study conclusions). Consensus discussions between authors led to the naming and understanding of the key themes. Results Seventy studies were included in the review. Study participants included final‐year medical students (n = 20), junior doctors early in internship (n = 24), and junior doctors late in internship or postgraduate year 2 and above (n = 23). Most studies explored work readiness through the retrospective self‐report of the students and/or junior doctor participants. Quantitative research methods elaborated on key skills‐based competencies, whereas qualitative research methods provided insight into key contextual and individual characteristics that contributed to preparedness. Conclusions Different research methods provided insight into competencies, as well as individual and contextual aspects, associated with preparedness for practice. The transition from university to clinical practice is significant and requires personal capability and confidence, as well as a supportive training context. Enabling students to engage authentically in clinical environments enhanced preparedness by promoting understanding of role and responsibility. Individual resilience is important, but contextual factors, including provision of adequate support and feedback, can enhance or subtract from feeling prepared. We propose a novel conceptual framework for better understanding work readiness.

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The do’s, don’t and don’t knows of supporting transition to more independent practice

Yardley

Westerman

Bartlett³

et al. 2018

Perspect Med Educ

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Introduction Transitions are traditionally viewed as challenging for clinicians. Throughout medical career pathways, clinicians need to successfully navigate successive transitions as they become progressively more independent practitioners. In these guidelines, we aim to synthesize the evidence from the literature to provide guidance for supporting clinicians in their development of independence, and highlight areas for further research. Methods Drawing upon D3 method guidance, four key themes universal to medical career transitions and progressive independence were identified by all authors through discussion and consensus from our own experience and expertise: workplace learning, independence and responsibility, mentoring and coaching, and patient perspectives. A scoping review of the literature was conducted using Medline database searches in addition to the authors' personal archives and reference snowballing searches. Results 387 articles were identified and screened. 210 were excluded as not relevant to medical transitions (50 at title screen; 160 at abstract screen). 177 full-text articles were assessed for eligibility; a further 107 were rejected (97 did not include career transitions in their study design; 10 were review articles; the primary references of these were screened for inclusion). 70 articles were included of which 60 provided extractable data for the final qualitative synthesis. Across the four key themes, seven do's, two don'ts and seven don't knows were identified, and the strength of evidence was graded for each of these recommendations. Conclusion The two strongest messages arising from current literature are first, transitions should not be viewed as one moment in time: career trajectories are a continuum with valuable opportunities for personal and professional development throughout. Second, learning needs to be embedded in practice and learners provided with authentic and meaningful learning opportunities. In this paper, we propose evidence-based guidelines aimed at facilitating such transitions through the fostering of progressive independence.

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Learning the house officer role: reflections on the value of shadowing a PRHO

Cited by 24 publications

References 7 publications

Training the intern: The value of a pre-intern year in preparing students for practice

Training the intern: The value of a pre-intern year in preparing students for practice

Transitioning from university to postgraduate medical training: A narrative review of work readiness of medical graduates

The do’s, don’t and don’t knows of supporting transition to more independent practice

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