Professional learning during the transition from trainee to newly qualified general practitioner

Abstract

The transition from training to qualified practice is inherently challenging. Structured support following training was once available, but this no longer exists and the current climate of primary care places increasing demands on GPs. Professional learning, and the transition to independent practice, may thus be problematic. To explore newly qualified GPs' experiences of professional learning following transition into qualified practice. Qualitative study using semi-structured interviews and a focus group, conducted between December 2010 and April 2011. Participants were GPs within five years of qualification, working in the East of England. Interviews were conducted with nine participants. These were followed by a focus group with four additional participants. Data collection, transcription and analysis were simultaneous, allowing iterative evolution of the topic guide to test emerging themes. New GPs wished to relinquish 'dependency' and become self-directed learners, yet still wanted guidance when needed. They described a situated experience of learning, in which inclusion in a practice community afforded greater learning opportunities. Social interactions also affected the issue of constructing an independent professional identity; a transitional process through which new GPs could become self-aware 'experts' with confidence in self-directed learning. Potential harms of the transitional period may be mitigated by support, which needs to emphasise inclusion, validation, affirmation and the provision of feedback. Preferences for adult learning should be encouraged, but guidance needs to be available when requested. Recent proposals for enhanced GP training introduce an opportunity for a focus on independent practice during training.