The doctor as an expert: apprentice, journeyman or master

Looi, Jeffrey; Yong, Choong-Siew

doi:10.5694/mja17.00255

Cited by 4 publications

(7 citation statements)

References 12 publications

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“…In Australia as well as the United States, longitudinal integrated clerkships place students alongside doctors to be authentic participants in patient care [ 14 ]. Potential benefits of experiential learning include better preparing PGY1s to be able to work with increased professionalism and expertise, particularly adaptive expertise [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

“You’re actually part of the team”: a qualitative study of a novel transitional role from medical student to doctor

Natalie

Tobin

et al. 2023

BMC Med Educ

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Background Optimizing transitions from final year of medical school and into first post graduate year has important implications for students, patients and the health care system. Student experiences during novel transitional roles can provide insights into potential opportunities for final year curricula. We explored the experiences of medical students in a novel transitional role and their ability to continue learning whilst working as part of a medical team. Methods Novel transitional role for final year medical students were created in partnership by medical schools and state health departments in 2020 in response to the COVID-19 pandemic and the need for a medical surge workforce. Final year medical students from an undergraduate entry medical school were employed as Assistants in Medicine (AiMs) in urban and regional hospitals. A qualitative study with semi-structured interviews at two time points was used to obtain experiences of the role from 26 AiMs. Transcripts were analyzed using deductive thematic analysis with Activity theory as a conceptual lens. Results This unique role was defined by the objective of supporting the hospital team. Experiential learning opportunities in patient management were optimized when AiMs had opportunities to contribute meaningfully. Team structure and access to the key instrument, the electronic medical record, enabled participants to contribute meaningfully, whilst contractual arrangements and payments formalized the obligations to contribute. Conclusions The experiential nature of the role was facilitated by organizational factors. Structuring teams to involve a dedicated medical assistant position with specific duties and access to the electronic medical record sufficient to complete duties are key to successful transitional roles. Both should be considered when designing transitional roles as placements for final year medical students.

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Section: Introductionmentioning

confidence: 99%

“You’re actually part of the team”: a qualitative study of a novel transitional role from medical student to doctor

Natalie

Tobin

et al. 2023

BMC Med Educ

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“…9 Medical students and doctors need to develop and excel as medical experts, and this requires the ability to objectively assess their own performance, receive feedback and improve their skills. 11 Nonetheless, we are not suggesting SET should be disregarded, as it may highlight experiences where students are feeling subject to bullying, harassment, and stigmatisation or being vicariously exposed to the same. SET can reveal important information about attitudes and experiences.…”

Section: Student Evaluation Of Teachingmentioning

confidence: 82%

Section: Student Evaluation Of Teachingmentioning

confidence: 99%

Between SET and ASP: balancing the scales of student evaluation of teaching (SET) and teachers’ assessments of student performance (ASP) for medical school education in psychiatry

Looi

Anderson²

2018

Australas Psychiatry

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“…While the importance of multidisciplinary collaboration is widely recognised, debate continues about how to acquire and measure these competences [ 8 , 9 ]. Residents are expected to learn to participate within MDTMs according to the master-apprentice principle, in which they learn ‘on the job’ by observing the medical specialists and assume increasingly active participative roles in discussions during their training [ 10 ]. This implies that the medical specialists function as good role models [ 7 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Residents are expected to learn to participate within MDTMs according to the master-apprentice principle, in which they learn ‘on the job’ by observing the medical specialists and assume increasingly active participative roles in discussions during their training [ 10 ]. This implies that the medical specialists function as good role models [ 7 , 10 ]. However, most of the medical specialists participating in oncological MDTMs are not trained to work in a multidisciplinary team (MDT).…”

Section: Introductionmentioning

confidence: 99%

Preparing tomorrow’s medical specialists for participating in oncological multidisciplinary team meetings: perceived barriers, facilitators and training needs

Walraven

Meulen²,

Hoeven³

et al. 2022

BMC Med Educ

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Introduction The optimal treatment plan for patients with cancer is discussed in multidisciplinary team meetings (MDTMs). Effective meetings require all participants to have collaboration and communication competences. Participating residents (defined as qualified doctors in training to become a specialist) are expected to develop these competences by observing their supervisors. However, the current generation of medical specialists is not trained to work in multidisciplinary teams; currently, training mainly focuses on medical competences. This study aims to identify barriers and facilitators among residents with respect to learning how to participate competently in MDTMs, and to identify additional training needs regarding their future role in MDTMs, as perceived by residents and specialists. Methods Semi-structured interviews were conducted with Dutch residents and medical specialists participating in oncological MDTMs. Purposive sampling was used to maximise variation in participants’ demographic and professional characteristics (e.g. sex, specialty, training duration, type and location of affiliated hospital). Interview data were systematically analysed according to the principles of thematic content analysis. Results Nineteen residents and 16 specialists were interviewed. Three themes emerged: 1) awareness of the educational function of MDTMs among specialists and residents; 2) characteristics of MDTMs (e.g. time constraints, MDTM regulations) and 3) team dynamics and behaviour. Learning to participate in MDTMs is facilitated by: specialists and residents acknowledging the educational function of MDTMs beyond their medical content, and supervisors fulfilling their teaching role and setting conditions that enable residents to take a participative role (e.g. being well prepared, sitting in the inner circle, having assigned responsibilities). Barriers to residents’ MDTM participation were insufficient guidance by their supervisors, time constraints, regulations hindering their active participation, a hierarchical structure of relations, unfamiliarity with the team and personal characteristics of residents (e.g. lack of confidence and shyness). Interviewees indicated a need for additional training (e.g. simulations) for residents, especially to enhance behavioural and communication skills. Conclusion Current practice with regard to preparing residents for their future role in MDTMs is hampered by a variety of factors. Most importantly, more awareness of the educational purposes of MDTMs among both residents and medical specialists would allow residents to participate in and learn from oncological MDTMs. Future studies should focus on collaboration competences.

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The doctor as an expert: apprentice, journeyman or master

Cited by 4 publications

References 12 publications

“You’re actually part of the team”: a qualitative study of a novel transitional role from medical student to doctor

“You’re actually part of the team”: a qualitative study of a novel transitional role from medical student to doctor

Between SET and ASP: balancing the scales of student evaluation of teaching (SET) and teachers’ assessments of student performance (ASP) for medical school education in psychiatry

Preparing tomorrow’s medical specialists for participating in oncological multidisciplinary team meetings: perceived barriers, facilitators and training needs

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