Abstract
BackgroundGraduating from medical school and beginning independent practice appears to be a major transition for medical students across the world. It is often reported that medical graduates are underprepared for independent practice. Most previous studies on undergraduates’ preparedness are cross-sectional. This study aimed to characterize the development and trend of medical students’ preparedness and its association with other objective and subjective indicators from the undergraduate to postgraduate periods.MethodsThis was a prospective cohort study. The participants were recruited and followed from two years before graduation to the postgraduate period. The preparedness for independent practice, professional identity, and teamwork experience were biannually measured using previously validated questionnaires. The participants’ basic demographic information, clinical learning marks from the last two years, and national board exam scores were also collected.ResultsA total of 85 participants completed 403 measurements in the 5 sequential surveys. The mean age at recruitment was 23.6, and 58 % of participants were male. The overall total preparedness score gradually increased from 157.3 (SD=21.2) at the first measurement to 175.5 (SD=25.6) at the fifth measurement. The serial individual preparedness scores revealed both temporal differences within the same learner and individual differences across learners. Despite the variations, a clear, steady increase in the overall average score was observed. Participants were least prepared in the domain of patient management at first, but the score increased in the subsequent measurements. The participants with better final preparedness had better professional identity (p<0.01), better teamwork experience (p < 0.01), and higher average clinical rotation marks (p<0.05).ConclusionsThe preparedness for practice of medical students from the undergraduate to postgraduate periods is associated with their professional identity, teamwork experience, and objective clinical rotation endpoint. Although preparedness generally increases over time, educators must understand that there are temporal fluctuations and individual differences in learners’ preparedness.
Highlights
Graduating from medical school and beginning independent practice appears to be a major transition for medical students across the world
The preparedness for practice of medical students from the undergraduate to postgraduate periods is associated with their professional identity, teamwork experience, and objective clinical rotation endpoint
Preparedness generally increases over time, educators must understand that there are temporal fluctuations and individual differences in learners’ preparedness
Summary
Graduating from medical school and beginning independent practice appears to be a major transition for medical students across the world. After receiving basic medical training, medical students undertake a period of rotatory clinical observership before graduation This period is called by different names, such as clerkship, (undergraduate) internship, or clinical placement [2, 3, 9]. Within this period, students’ clinical learning is directed by clinical educators, who are responsible for facilitating the acquisition of profession-specific skills while students are in the field [10, 11]. Students graduate and pass the board examination, after which they begin independent practice under supervision in the hospital This postgraduate stage could be a (postgraduate) internship, postgraduate year (PGY) rotation, or residency, depending on the system [1, 2, 7]
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