Intra- and interprofessional practices through fresh eyes: a qualitative analysis of medical students’ early workplace experiences
Abstract Background Professional identities are influenced by experiences in the clinical workplace including socialisation processes that may be hidden from academic faculty and potentially divergent from formal curricula. With the current educational emphasis on complexity, preparedness for practi...
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| Format: | Article |
| Language: | English |
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BMC
2019-07-01
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| Series: | BMC Medical Education |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12909-019-1722-8 |
| _version_ | 1818318225075601408 |
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| author | Kathleen E. Leedham-Green Alec Knight Rick Iedema |
| author_facet | Kathleen E. Leedham-Green Alec Knight Rick Iedema |
| author_sort | Kathleen E. Leedham-Green |
| collection | DOAJ |
| description | Abstract Background Professional identities are influenced by experiences in the clinical workplace including socialisation processes that may be hidden from academic faculty and potentially divergent from formal curricula. With the current educational emphasis on complexity, preparedness for practice, patient safety and team-working it is necessary to evaluate and respond to what students are learning about collaborative practices during their clinical placements. Methods 394 second year medical students at a London medical school were invited to submit a short formative essay as part of their coursework describing, evaluating and reflecting on their experiences of how healthcare professionals work together. Their experiences were derived from having spent two days each week for 25 weeks in clinical contexts across primary and secondary care. We consented 311 participants and used a Consensual Qualitative Research approach to analyse these essays, creating a ‘students-eye view’ of intra- and interprofessional practices in the workplace. Results We identified four overarching themes in students’ essays:Theme 1: analyses of contextual factors driving team tensions including staff shortages, shifting teams, and infrastructural issues;Theme 2: observations of hierarchical and paternalistic attitudes and behaviours;Theme 3: respect for team members’ ability to manage and mitigate tensions and attitudes; andTheme 4: take-forward learning including enthusiasm for quality improvement and system change. Conclusions Students are being socialised into a complex, hierarchical, pressurised clinical workplace and experience wide variations in professional behaviours and practices. They articulate a need to find constructive ways forward in the interests of staff wellbeing and patient care. We present educational recommendations including providing safe reflective spaces, using students’ lived experience as raw material for systems thinking and quality improvement, and closing the feedback loop with placement sites on behalf of students. |
| first_indexed | 2024-12-13T09:49:50Z |
| format | Article |
| id | doaj.art-79db7f000d8e47d8bde10cd6b9968194 |
| institution | Directory Open Access Journal |
| issn | 1472-6920 |
| language | English |
| last_indexed | 2024-12-13T09:49:50Z |
| publishDate | 2019-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Education |
| spelling | doaj.art-79db7f000d8e47d8bde10cd6b99681942022-12-21T23:51:57ZengBMCBMC Medical Education1472-69202019-07-011911910.1186/s12909-019-1722-8Intra- and interprofessional practices through fresh eyes: a qualitative analysis of medical students’ early workplace experiencesKathleen E. Leedham-Green0Alec Knight1Rick Iedema2Medical Education Research Unit, Imperial College LondonDepartment of Population Health Sciences, King’s College LondonCentre for Team-based Practice & Learning in Health Care, King’s College LondonAbstract Background Professional identities are influenced by experiences in the clinical workplace including socialisation processes that may be hidden from academic faculty and potentially divergent from formal curricula. With the current educational emphasis on complexity, preparedness for practice, patient safety and team-working it is necessary to evaluate and respond to what students are learning about collaborative practices during their clinical placements. Methods 394 second year medical students at a London medical school were invited to submit a short formative essay as part of their coursework describing, evaluating and reflecting on their experiences of how healthcare professionals work together. Their experiences were derived from having spent two days each week for 25 weeks in clinical contexts across primary and secondary care. We consented 311 participants and used a Consensual Qualitative Research approach to analyse these essays, creating a ‘students-eye view’ of intra- and interprofessional practices in the workplace. Results We identified four overarching themes in students’ essays:Theme 1: analyses of contextual factors driving team tensions including staff shortages, shifting teams, and infrastructural issues;Theme 2: observations of hierarchical and paternalistic attitudes and behaviours;Theme 3: respect for team members’ ability to manage and mitigate tensions and attitudes; andTheme 4: take-forward learning including enthusiasm for quality improvement and system change. Conclusions Students are being socialised into a complex, hierarchical, pressurised clinical workplace and experience wide variations in professional behaviours and practices. They articulate a need to find constructive ways forward in the interests of staff wellbeing and patient care. We present educational recommendations including providing safe reflective spaces, using students’ lived experience as raw material for systems thinking and quality improvement, and closing the feedback loop with placement sites on behalf of students.http://link.springer.com/article/10.1186/s12909-019-1722-8EducationMedicalUndergraduateHidden curriculumInterprofessional educationAttitudes |
| spellingShingle | Kathleen E. Leedham-Green Alec Knight Rick Iedema Intra- and interprofessional practices through fresh eyes: a qualitative analysis of medical students’ early workplace experiences BMC Medical Education Education Medical Undergraduate Hidden curriculum Interprofessional education Attitudes |
| title | Intra- and interprofessional practices through fresh eyes: a qualitative analysis of medical students’ early workplace experiences |
| title_full | Intra- and interprofessional practices through fresh eyes: a qualitative analysis of medical students’ early workplace experiences |
| title_fullStr | Intra- and interprofessional practices through fresh eyes: a qualitative analysis of medical students’ early workplace experiences |
| title_full_unstemmed | Intra- and interprofessional practices through fresh eyes: a qualitative analysis of medical students’ early workplace experiences |
| title_short | Intra- and interprofessional practices through fresh eyes: a qualitative analysis of medical students’ early workplace experiences |
| title_sort | intra and interprofessional practices through fresh eyes a qualitative analysis of medical students early workplace experiences |
| topic | Education Medical Undergraduate Hidden curriculum Interprofessional education Attitudes |
| url | http://link.springer.com/article/10.1186/s12909-019-1722-8 |
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