Student assistantship programme: an evaluation of impact on readiness to transit from medical student to junior doctor

Relationships between self-efficacy beliefs and personal factors in final-year medical students

BACKGROUND

Medical students entering postgraduate training often feel ill-prepared for clinical practice. This has implications for physician well-being and the quality of patient care. Self-efficacy represents an important contributing factor in the transition process. Identifying student characteristics associated with self-efficacy is important in order to design possible interventions to enhance self-efficacy. Therefore, we assessed the relationship between final-year medical students' general self-efficacy with their personality traits, need for cognitive closure, and medical knowledge in order to identify factors contributing to the assessment and improvement of self-efficacy.

METHODS

Self-assessed data regarding general self-efficacy was collected from 188 final-year medical students who participated in a first day of residency simulation between March and September 2023. We also assessed several personal factors including the HEXACO Personality Inventory Revised (HEXACO-PI-R), a short scale to measure Need for Cognitive Closure (16-NCCS), and students' medical exam grades (M2). We ran multiple correlation and multiple linear regression analyses across all variables. We then added a second analysis each with general self-efficacy and HEXACO domains Emotionality and Extraversion on facet level, which both showed significant associations with self-efficacy in the respective first analysis.

RESULTS

Across all variables, self-efficacy correlated significantly negatively with Emotionality and positively with Extraversion. Both domains also significantly predicted self-efficacy accordingly in the regression model. On a facet analysis, Sentimentality (Emotionality) and Sociability (Extraversion) did not correlate significantly with self-efficacy. In the regression model only the facets Sociability (Extraversion) and Fearfulness (Emotionality) significantly predicted lower self-efficacy. Furthermore, self-efficacy correlated significantly and negatively with the Need for Cognitive Closure (NCC). Additionally, significant positive and negative correlations of the NCC with both Emotionality and Extraversion, respectively, as well as a significant positive correlation for exam grades (M2) and Extraversion were found.

CONCLUSIONS

Self-efficacy contributes to medial students' preparedness for clinical practice and can be predicted by several personal factors. Students should learn and reflect about these factors and need to be supported in increasing their self-efficacy and its self-assessment towards their transition to postgraduate training. Construction of a specific instrument for self-efficacy assessment utilizing the insight provided by the findings is proposed as a next step.

Learning needs of junior doctors in otolaryngology: a qualitative study

OBJECTIVES

There is concern that junior doctors are not prepared for their post-graduate attachments in ENT. The aims of this study were to capture the learning priorities of those in the ENT first on-call role and facilitate further educational opportunities to address these needs.

METHOD

Semi-structured interviews were undertaken to explore the learning needs of junior doctors with seven junior and two senior ENT clinicians.

RESULTS

The thematic analysis generated three themes: the role of the ENT Junior; the perceived, expressed and prescribed learning needs; and attitudes towards future learning. These themes explored the misalignment between undergraduate training and post-graduate expectations, the lack of competence in ENT practical skills and the need for focused ENT training prior to commencing on-call shifts.

CONCLUSION

All interviewees identified the need for greater experience in practical interventional skills prior to their ENT attachments and expressed interest towards a standardised, bootcamp-style induction with simulated emergency experience.

Junior doctors' workplace well-being and the determinants based on ability-motivation-opportunity (AMO) theory: Educational and managerial implications from a three-year longitudinal observation after graduation

PURPOSE

Junior doctors function as trainees from an educational perspective and as employees from a human resource management perspective. Employing the ability-motivation-opportunity (AMO) theory as a conceptual framework, this study longitudinally investigated the factors affecting the workplace well-being and career progression of junior doctors over a 3-year period following their graduation from medical schools.

MATERIALS AND METHODS

This 3-year prospective cohort study enrolled junior doctors who graduated from 2 medical schools in June 2019 in Taiwan. This study collected data by implementing web-based, self-administered structured questionnaires at 3-month intervals between September 2019 and July 2022. The collected data encompassed ability indicators (i.e. academic performance and perceived preparedness for clinical practice), motivation indicators (i.e. educational and clinical supervision), opportunity indicators (i.e. clinical unit cultures), and workplace well-being indicators (i.e. burnout, compassion satisfaction, and job performance). A total of 107 junior doctors participated, providing 926 total responses. The data were analysed using univariate analyses and structural equation modelling with path analysis.

RESULTS

Over the 3-year period following graduation, the junior doctors' confidence in their preparedness for clinical practice and the educational and clinical supervision had varying degrees of influence on the junior doctors' workplace well-being. The influence of clinical unit cultures, which can provide opportunities for junior doctors, became evident starting from the second year postgraduation; notably, unit cultures that emphasised flexibility and discretion played positive and critical roles in enhancing the junior doctors' workplace well-being lasted to the third year.

CONCLUSIONS

Our findings provide insights into the distinct critical factors that affect the socialisation of junior doctors within workplace environments over 3 consecutive years. These findings can provide guidance for medical educators and healthcare managers, helping them understand and support the progressive integration of junior doctors into their work environments.

Role of social comparison in preparedness for practice as a junior doctor in Singapore: a longitudinal qualitative study

OBJECTIVES

To date, most research on medical graduates' preparedness for practice has conceptualised preparedness as something possessed by the individual. However, new doctors work within social settings with other people and, given this, we argue that preparedness has a social and comparative dimension. The aim of this paper is to explore medical students'/graduates' self-assessments of their preparedness for practice using the lens of social comparison theory.

SETTING

We invited medical students from one of Singapore's three medical schools who were in their final-year Student Assistantship Programme to participate in semi-structured interviews, and follow-up interviews 6 months later when they were working as junior doctors. Data was collected from two cohorts, in 2018 and 2019. Initial analysis of interview transcripts was inductive and thematic. Social comparison theory was used for subsequent theory-driven analysis.

PARTICIPANTS

31 participants took part, of whom 21 also engaged in follow-up interviews.

RESULTS

We identified three uses of social comparison: as coping strategy to manage uncertainties in transitions where there was no formal, objective testing of their performance; as a means to confirm their self-perceived preparedness (upwards or downwards, eg, being better or worse prepared than comparator others); and as the basis for decision-making (eg, changing career choices).

CONCLUSIONS

Senior medical students and newly-graduated doctors compare themselves with peers and near-peers in terms of prior learning and current performance to evaluate and understand their own performance at work. Future studies need to examine further how the feeling of preparedness or unpreparedness generated from social comparisons may affect subsequent clinical performance and professional development.