Learning on the fly: How rural junior doctors learn during consultations with retrieval physicians.

Abstract

This study explores how rural junior doctors learn while consulting retrieval physicians about critically ill and injured patients, as well as the tensions characterising teaching and learning in this setting. Data were collected via three focus groups, involving rural junior doctors (n = 8), rural senior doctors (n = 3) and retrievalists (n = 3). The discussions were transcribed and subject to multistage coding. Rural junior doctors believe they learn from interactions with retrieval physicians. Their learning was greatest when the retrieval physician explained his or her clinical reasoning and provided feedback. The level of stress was sometimes overwhelming and learning ceased. Both groups described limited time for teaching due to the medical needs of the patient and the needs of concurrent patients. Retrieval physicians were not certain that rural junior doctors wanted to learn. Rural junior doctors hold retrievalists in very high regard. Support provided by retrievalists extends the abilities of the junior doctors and often results in learning. When junior doctors are extended too far, they become overwhelmed and learning ceases. Junior doctors would like the retrievalists to spend more time explaining their actions and providing feedback. Even when both retrievalists and junior doctors are interested in teaching, it may not occur due to misunderstandings and differences in status.