Participation and progression: new medical graduates entering professional practice

Bearman, Margaret; Lawson, Mary; Jones, Alison

doi:10.1007/s10459-011-9284-5

Cited by 25 publications

(42 citation statements)

References 17 publications

(21 reference statements)

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“…The two‐stage screening process resulted in 92 studies included in the scoping review . Of these, 57 investigated PIF in medical students and/or residents, 26 involved nurse trainees (associate, bachelor, graduate and nurse managers), and nine involved counselling or psychology undergraduate or graduate students …”

Section: Resultsmentioning

confidence: 99%

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Is research on professional identity formation biased? Early insights from a scoping review and metasynthesis

et al. 2019

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OBJECTIVE Despite a recent surge in literature identifying professional identity formation (PIF) as a key process in physician development, the empiric study of PIF in medicine remains in its infancy. To gain insight about PIF, the authors examined the medical literature and that of two other helping professions.METHODS The authors conducted a scoping review and qualitative metasynthesis of PIF in medicine, nursing and counselling/psychology. For the scoping review, four databases were searched using a combination of keywords to identify empiric studies on PIF in trainees. After a two-step screening process, thematic analysis was used to conduct the metasynthesis on screened articles. RESULTSA total of 7451 titles and abstracts were screened; 92 studies were included in the scoping review. Saturation was reached in the qualitative metasynthesis after reviewing 29 articles.CONCLUSION The metasynthesis revealed three inter-related PIF themes across the helping professions: the importance of clinical experience, the role of trainees' expectations of what a helping professional is or should be, and the impact of broader professional culture and systems on PIF. Upon reflection, most striking was that only 10 of the 92 articles examined trainee's sociocultural data, such as race, ethnicity, gender, sexual orientation, age and socioeconomic status, in a robust way and included them in their analysis and interpretation. This raises the question of whether conceptions of PIF suffer from sociocultural bias, thereby disadvantaging trainees from diverse populations and preserving the status quo of an historically white, male medical culture.Professional identity formation (PIF) in medicine focuses attention on the career-long process of becoming a clinician. 1,2 PIF can be thought of as a double helix: the individual and the profession form parallel strands that become intertwined. Each strand must bend in order to accommodate the other; however, this burden of bending and changing to accommodate seems to fall more acutely on the individual strand, with the profession's strand remaining more fixed. PIF frequently involves experimentation, change and uncertainty, and ideally results in the successful reconciliation of conflicting ideals, values and roles. Although successful formation of a professional identity has been linked to career success 3 and creativity at work, 4 a mismatch between an individual's internal bearings and the roles and expectations of the profession can create anxiety, frustration and feelings of inadequacy, and can result in the individual leaving the profession. 5 The role of culture, race, socioeconomic status and gender might be expected to be critical components of the individual strand, and could prove to be important confounders in the study of this complex process.We set out to gain an understanding of the current state of the PIF literature in medicine by conducting a scoping review and metasynthesis of the literature across three of the helping professions (medicine, nursing and counselling/ p...

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Section: Resultsmentioning

confidence: 99%

“…Of these, 57 investigated PIF in medical students and/or residents, 26 involved nurse trainees (associate, bachelor, graduate and nurse managers), and nine involved counselling or psychology undergraduate or graduate students . Three of the studies had a mixed‐methods design, six were quantitative and 83 were qualitative …”

Section: Resultsmentioning

confidence: 99%

Is research on professional identity formation biased? Early insights from a scoping review and metasynthesis

et al. 2019

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“…Much of our understanding about how the transition is experienced is based on opinions and attitudes of residents looking back at the transition to clinical practice. Less emphasis in the literature has been placed on exploring the experience of medical students and recent graduates as they contemplate the transition . Studies that have focused on competence and preparedness have provided us with some appreciation of the student perspective .…”

Section: Introductionmentioning

confidence: 99%

‘Waiting in the wings’; Lived experience at the threshold of clinical practice

2019

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Context The transition to clinical practice is challenging. Lack of preparedness and issues with support, responsibility and complex workplace interactions contribute to the difficulties encountered. The first year of clinical practice is associated with negative consequences for new doctors’ health and well‐being. The contemporaneous lived experience of new graduates on the threshold of clinical practice has not been described. Deeper understanding of this phase may inform interventions to ease the transition from student to doctor. Methods We used interpretative phenomenological analysis (IPA) to explore the individual experience of making the transition from medical student to doctor, focusing on the period prior to commencing clinical practice. Fourteen recent graduates were purposively recruited, and semi‐structured interviews were conducted with each, with respect to how they anticipated the transition. Results We draw on the metaphor of the actor ‘waiting in the wings’ to describe participants’ lived experience on the threshold of practice. The experience of the actor, about to step into the spotlight, was mirrored in participants’ perceptions of an abrupt transformation to come, mixed feelings about what lay ahead, and the various strategies that they had planned to help them to perform their new role convincingly. Discussion Participants in this study braced themselves for a trial by ordeal as they contemplated commencing clinical practice. The hidden curriculum shaped their understanding of what was expected of them as new doctors, and inspired dysfunctional strategies to meet expectations. Solutions to make the experience a more positive one lie in the approximation of the roles of senior medical student and newly qualified doctor, in explicitly addressing the hidden curriculum and generating cultural change. An emphasis on experience‐based learning through contribution to patient care, guided reflection on the hidden curriculum and shifting cultural expectations through faculty development and strong local leadership can contribute to these objectives.

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“…Although there is a degree of congruence between these findings and those from other professions (e.g. teaching[17]; medicine[23,24]; and nursing[25]), the issues being experienced by pharmacy graduates suggests that there may be factors unique to pharmacy hampering graduates' identity formation. In particular, pharmacy is changing, i.e.…”

Section: Introductionmentioning

confidence: 83%

Making the transition from pharmacy student to pharmacist: Australian interns’ perceptions of professional identity formation

Noble

Coombes

Nissen

et al. 2014

International Journal of Pharmacy Practice

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This paper argues that graduates' experience of the transition to practice was challenging. This was due to nascent professional identities formed in university and a lack of workplace experiences enabling patient-centred practices. The interns' formation of professional identities was highly responsive to the context of work. To facilitate the development of Australian patient-centred pharmacy practice, supporting professional identity formation should be a focus within pharmacy education.

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Participation and progression: new medical graduates entering professional practice

Cited by 25 publications

References 17 publications

Is research on professional identity formation biased? Early insights from a scoping review and metasynthesis

Is research on professional identity formation biased? Early insights from a scoping review and metasynthesis

‘Waiting in the wings’; Lived experience at the threshold of clinical practice

Making the transition from pharmacy student to pharmacist: Australian interns’ perceptions of professional identity formation

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