The transition to hospital consultant and the influence of preparedness, social support, and perception: A structural equation modelling approach

Westerman, Michiel; Teunissen, Pim W.; Fokkema, Joanne P. I.; Vleuten, Cees van der; Scherpbier, Albert; Siegert, C. E. H.; Scheele, Fedde

doi:10.3109/0142159x.2012.735381

Cited by 70 publications

(87 citation statements)

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“…Although new consultants are generally satisfied with their training in clinical skills (McKinstry et al 2005;Beckett et al 2006), they feel less prepared for their non-clinical tasks, in particular, in the area of management and (financial) organization (Higgins et al 2005;Beckett et al 2006;Morrow et al 2009;Berkenbosch et al 2011). As a result, such tasks are experienced as stressful (Beckett et al 2006) and there is evidence to suggest that insufficient training in these tasks is related to stress and burnout among new consultants (Westerman et al 2013a). A better understanding of the shortcomings new consultants experience in their preparation for independent practice could help to prevent the negative societal, personal and financial consequences of such problematic transitions.…”

Section: Introductionmentioning

confidence: 99%

Preparedness for practice: A systematic cross-specialty evaluation of the alignment between postgraduate medical education and independent practice

et al. 2014

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Section: Introductionmentioning

confidence: 99%

Preparedness for practice: A systematic cross-specialty evaluation of the alignment between postgraduate medical education and independent practice

et al. 2014

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“…Ochsmann [2] reported that among 637 German residents, adverse work characteristics, such as work-related support, availability of postgraduate training possibilities and overtime, increase the risk of thinking about leaving clinical care. Furthermore, Westerman et al [13] showed for transition from specialty training to a position as hospital consultant that social support facilitates the process through this phase . Among later-career doctors, work characteristics also determine intention to leave clinical practice.…”

Section: Introductionmentioning

confidence: 99%

The impact of training and working conditions on junior doctors’ intention to leave clinical practice

et al. 2014

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BackgroundThe shortage of physicians is an evolving problem throughout the world. In this study we aimed to identify to what extent junior doctors’ training and working conditions determine their intention to leave clinical practice after residency training.MethodsA prospective cohort study was conducted in 557 junior doctors undergoing residency training in German hospitals. Self-reported specialty training conditions, working conditions and intention to leave clinical practice were measured over three time points. Scales covering training conditions were assessed by structured residency training, professional support, and dealing with lack of knowledge; working conditions were evaluated by work overload, job autonomy and social support, based on the Demand–Control–Support model. Multivariate ordinal logistic regression analyses with random intercept for longitudinal data were applied to determine the odds ratio of having a higher level of intention to leave clinical practice.ResultsIn the models that considered training and working conditions separately to predict intention to leave clinical practice we found significant baseline effects and change effects. After modelling training and working conditions simultaneously, we found evidence that the change effect of job autonomy (OR 0.77, p = .005) was associated with intention to leave clinical practice, whereas for the training conditions, only the baseline effects of structured residency training (OR 0.74, p = .017) and dealing with lack of knowledge (OR 0.74, p = .026) predicted intention to leave clinical practice.ConclusionsJunior doctors undergoing specialty training experience high workload in hospital practice and intense requirements in terms of specialty training. Our study indicates that simultaneously improving working conditions over time and establishing a high standard of specialty training conditions may prevent junior doctors from considering leaving clinical practice after residency training.

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“…This study used self-reported measures, which have the potential for bias 11. However, the questionnaires were matched to pre and post perception.…”

Section: Limitationsmentioning

confidence: 99%

Exploration of ‘perception of self’ as medical leader: does perception of self require a paradigm shift from clinician to clinical leader?

Moen

Brown

Kaehne

2018

leader

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BackgroundClinical leadership is key to quality improvement; however, there is limited research regarding doctors’ perceptions of clinical leadership.AimTo investigate senior trainees’ perception of self as medical leader and explore what influenced their perception.MethodsA questionnaire with open and closed questions was distributed before and after a medical leadership module. Twelve trainees were then interviewed.ResultsOne hundred and fifty-six questionnaires were completed (95.7 % response rate). A significant number of senior trainees did not consider themselves to be a leader; however, there was a statistically significant shift in their self-perception during the programme. Themes identified during the interviews included a lack of understanding of the leadership concept, a lack of clarity of the medical leader’s role and vehicles for perspective transformation.ConclusionsTo our knowledge, this is the first study to explore senior trainees’ perception of self as medical leader. Findings suggest, following a paradigm shift from clinician to clinical leader, senior trainees are a potential, valuable resource for quality improvement. To aid understanding of the leadership self-development process, a conceptual model is offered. The significance of the model is its focus on the individual’s leadership paradigm, as the starting point for self-exploration. This model could inform leadership development programmes.

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The transition to hospital consultant and the influence of preparedness, social support, and perception: A structural equation modelling approach

Abstract: These findings illustrate the relevance of generic competencies for new hospital consultants. Furthermore, social support facilitates this intense and stressful stage within the medical career.

Cited by 70 publications

References 35 publications

Preparedness for practice: A systematic cross-specialty evaluation of the alignment between postgraduate medical education and independent practice

Preparedness for practice: A systematic cross-specialty evaluation of the alignment between postgraduate medical education and independent practice

The impact of training and working conditions on junior doctors’ intention to leave clinical practice

Exploration of ‘perception of self’ as medical leader: does perception of self require a paradigm shift from clinician to clinical leader?

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