Exploring health care graduates' conceptualisations of preparedness for practice: A longitudinal qualitative research study

Abstract

Introduction Although preparedness for practice (P4P) has been variously described, little shared understanding exists about what P4P is across the health professions. How P4P is conceptualised matters, because this shapes how stakeholders think, talk about and act towards it. Further, multiple understandings can result in diverse expectations for graduate performance. This study therefore explores health care learners’ solicited and unsolicited conceptualisations of P4P over their early graduate transition. Methods We conducted longitudinal qualitative research including individual and group entrance interviews (phase 1: n = 35), longitudinal audio‐diaries (phase 2: n = 30), and individual and group exit interviews (phase 3: n = 22) with learners from four disciplines (dietetics, medicine, nursing and pharmacy). We employed framework analysis to interrogate data cross‐sectionally and longitudinally. Results We found 13 conceptualisations of P4P (eg knowledge, confidence), broadly similar across the disciplines. We found some conceptualisations dominant in both solicited and unsolicited talk (eg skills), some dominant only in solicited talk (eg competence) and others dominant only in unsolicited talk (eg experience). Although most conceptualisations appeared relatively stable across time, some appeared to dominate at certain time points only (eg employability and skills in phases 1 and 2, and competence in phase 3). Discussion This novel study extends previous uniprofessional work by illustrating a broader array of conceptualisations, differences between professions, solicited versus unsolicited talk and longitudinal cohort patterns. We encourage health care educators to discuss these different P4P understandings in graduate transition interventions. Further research is needed to explore other stakeholders’ conceptualisations, and over a duration beyond the early graduate transition.

Transition from undergraduates to residents: A SWOT analysis of the expectations and concerns of Japanese medical graduates during the COVID-19 pandemic

“…However, the results of this study suggest that residents who have experienced disruption in clinical clerkship, during their undergraduate medical education due to the pandemic, not only lack confidence in these areas, but also feel anxious about patient contact. Although graduates perceive that their readiness to work can be improved by increased independence after a few months in a new position [ 34 ], direct observation by their supervisors and detailed feedback should be implemented to alleviate their concerns. Although direct observation is recognised as a valid and reliable assessment tool, some learners feel ambivalent about being observed [ 35 ], and supervisors should consider this.…”

Longitudinal qualitative research in medical education: Time to conceptualise time

“…For this illustrative overview, we included 19 papers. 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 We summarise study characteristics in Table S1 (see Appendix S1 ) and highlight several papers in this section.…”

“…Recursive data collection enables participants to narrate their own growth, with its own pace and rhythm ( time‐as‐fluid ). To be clear, interviews are not the only way collect data recursively; longitudinal audio diaries 21 , 23 , 25 , 28 , 40 and reflective writings 34 , 35 have also been used.…”

“…She added five papers from her personal collection of LQR that were not readily identifiable as longitudinal and recursive. For this illustrative overview, we included 19 papers 20‐38 . We summarise study characteristics in Table S1 (see Appendix ) and highlight several papers in this section.…”

Gender Matters: Understanding Transitions in Surgical Education

“…Westerman and Teunissen [( 14 ), p. 372] define a medical transition as “a period of change in which medical students or doctors experience a discontinuity in their professional life space forcing them to respond by developing new behaviours or changing their professional life space to cope with a new situation.” Only a few recent studies in healthcare have used MMT theory to better understand medical transitions. These include a Scottish study of the trainee-to-trained doctor transition, including the development of a conceptual model of the trainee-trained doctor transition ( 15 , 16 , 19 ), an Australian study exploring new healthcare graduates’ transitions ( 17 ) and an English study exploring new doctors’ transitions to practice utilising participant-voiced poetry ( 18 ). Most relevant to the current paper, Gordon et al ( 16 ) developed the Transition-To-Trained Doctor (T3D) model to reflect the complexity of how doctors experience trainee-trained doctor transitions, taking into account various personal and professional domains and contexts.…”