Does a new undergraduate curriculum based on ‘Tomorrow’s Doctors’ prepare house officers better for their first post? A qualitative study of the views of pre-registration house officers using critical incidents

Paul A O'Neill, Alison Jones, Sarah C Willis, Patricia J McArdle

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Introduction In 1994 Manchester University introduced an integrated undergraduate medical course using problem‐based learning (PBL) throughout. The study reported here explored whether there were any differences between the new course graduates (NCGs) and the traditional course graduates (TCGs) in the types of scenarios they recalled as ‘critical incidents’, or challenging cases, while working as pre‐registration house officers (PRHOs). The focus is on differences rather than causal links.

Method We used semistructured interviews to generate our data. Twenty‐four traditional course graduates and 23 new course graduates were interviewed approximately 3 months after starting their first PRHO placement.

Results We identified 4 types of critical incidents relating to: clinical practice; limitations of competence; emotional involvement; and communication. Traditional course graduates reported difficulties in making patient management decisions, whereas the NCGs were better at dealing with uncertainty, knowing their limits and asserting their rights for support. Communication difficulties and coping with emotional involvement were common across both groups of graduates and hence remain problems in relation to being prepared for the role of a PRHO.

Conclusions Graduates of the new, integrated curriculum seemed to be much better at dealing with uncertainty, knowing their personal limits and asserting their rights for support when they felt these limits had been reached. Communication difficulties and emotional involvement remain major factors in the transition from student to PRHO.
Original languageEnglish
Pages (from-to)1100-1108
Number of pages9
JournalMedical Education
Volume37
Issue number12
DOIs
Publication statusPublished - Dec 2003
Externally publishedYes

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