Doctors and teachers in their first year of practice face steep learning curves and increased stress, which can induce poor mental health, burnout and attrition. Informal workplace support from colleagues can help smooth transitions and aid professional development. A three‐phase comparative research design was used to explore who provides informal workplace support to early‐career professionals, types of support and influencing factors. Phase 1 was a systematic secondary analysis of interviews and audio diaries from 52 UK doctors in their first year of foundation training (F1s). Phase 2 involved new narrative interviews with 11 newly qualified teachers (NQTs) from English secondary schools. Phase 3 was a comparative analysis to produce a model of workplace support. Given barriers to accessing senior doctors, F1 doctors drew upon nurses, pharmacists, microbiologists, peers/near‐peers and allied healthcare professionals for support. NQTs gained support from allocated mentors and seniors within subject departments, as well as teaching assistants, allied support staff and wider professional networks. Support types for both professions included information and advice on practice, orientation to local settings, collaborative development activities, observation and feedback, and socioemotional support. Influencing factors included variable departmental cultures, limited opportunities for informal contact, sometimes negative inter‐group perceptions and the agentic responses of novices. The resulting workplace model of support could underpin future research and evaluations of support in similar ‘hot‐action’ environments. In medicine and teaching, greater utilisation of near‐peers and allied staff, improved role understanding and communication, increased informal contact and sharing successful strategies across professions could enhance supportive relationships.
Feedback can be a powerful tool for promoting healthcare safety. However, 'feedback' as a concept tends to embody a number of implicit assumptions arising from behaviourist educational traditions, such as power differentials between feedback providers and receivers, unidirectionality of transmission, and simple notions of 'error'. Such assumptions can present challenges when designing and implementing feedback initiatives to address complex problems within healthcare such as improving prescribing. Sociocultural conceptions of feedback may be helpful in such cases, so that correspondingly complex solutions can be formulated.The purpose of this article therefore, is to step back and reconsider the nature and value of the term 'feedback' when applied to complex healthcare problems. We consider a number of different conceptions, definitions and understandings of feedback, using our own research on optimising prescribing as a case study and drawing upon our joint reflexive discussions as a team. In doing so, we examine the differences between simple, complicated and complex problems and how these might relate to feedback in medical education. We also explore alternative but related terms to feedback, considering their similarities, differences, and the appropriateness of each when applied to complex activities such as prescribing. Finally, we reflect on the dilemma of whether the medical education community should persevere with using a term which eludes embedded shared conceptualisation, perhaps redefining it to better reflect contemporary usage, or embrace a different term altogether. By sharing our experiences as a research team grappling with a challenging topic, we hope to engage with the wider community and their insights, in order to benefit our own research and the medical education research field.
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