What trainees grapple with: a study of threshold concepts on the medicine ward.
OBJECTIVES Socialisation theories of professional identity formation (PIF) consider clinical rotations to be critically intense transformative experiences. However, few studies have explored what trainees grapple with during these transformative experiences or their influence on performance. Applyin...
| Published in: | Medical Education Vol. 52; no. 6; pp. 620 - 632 |
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| Main Authors: | , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Wiley-Blackwell
Jun2018
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=129961534&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 129961534 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03080110 ESF jtl: Medical Education issn: 03080110 maglogo: Y pubinfo: dt: Jun2018 vid: 52 iid: 6 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 129961534 129961534 129961534 10.1111/medu.13526 129961534 ppf: 620 ppct: 12 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: What trainees grapple with: a study of threshold concepts on the medicine ward. aug: au: Bhat, Chirag Burm, Sarah Mohan, Tricia Chahine, Saad Goldszmidt, Mark affil: Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London ON, Canada sug: subj: Interns and Residents Education, Medical Hospital Units Human Professional Development Grounded Theory Patient Care Internship and Residency Teamwork ab: OBJECTIVES Socialisation theories of professional identity formation (PIF) consider clinical rotations to be critically intense transformative experiences. However, few studies have explored what trainees grapple with during these transformative experiences or their influence on performance. Applying a threshold concepts (TCs) lens, this study investigates and documents 'troublesome' and 'transformative' concepts that junior trainees may encounter during a clinical rotation. Insights gained are essential for supporting trainee development. METHODS Constructivist grounded theory was used to guide the collection and analysis of data for this two-phase study. Phase 1 involved direct observation and field interviews with 17 junior trainees over two observation periods and phase 2 involved in-depth interviews with 13 attending physicians. The theory of TCs was used as a sensitising concept. RESULTS In total, nine TCs were identified and thematically grouped under the headings: Developing as a Professional, Providing Patient Care and Working Collectively. Across the interviewed attending physicians, there appeared to be a shared understanding of TCs strong trainees had crossed and weaker trainees struggled with. Observational and field interview data suggested that individual trainee actions were strongly influenced by the identified TC and whether or not the trainee appeared to have crossed any given threshold. Moreover, individual clinical practices could be influenced by more than one TC. Trainees were also observed to vary in the thresholds they had already crossed or struggled with. CONCLUSIONS The identified TCs offer important insights into the relationship between trainee actions and how they conceptualise practice. At their heart, many appeared to represent ideals of practice that trainees should incorporate into their developing identities as they explore what it means to be a physician. Future research should explore how to incorporate TCs into assessment and the support of trainee development. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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