Abstract
BackgroundThe transition from medical student to junior doctor is one of the most challenging in medicine, affecting both doctor and patient health. Opportunities to support this transition have arisen from advances in mobile technology and increased smartphone ownership.MethodsThis qualitative study consisted of six in-depth interviews and two focus groups with Foundation Year 1 Trainees (intern doctors) and final year medical students within the same NHS Trust. A convenience sample of 14 participants was recruited using chain sampling. Interviews and focus groups were recorded, transcribed verbatim, analysed in accordance with thematic analysis and presented below in keeping with the standards for reporting qualitative research.ResultsParticipants represented both high and low intensity users. They used their smartphones to support their prescribing practices, especially antimicrobials through the MicroGuide™ app. Instant messaging, via WhatsApp, contributed to the existing bleep system, allowing coordination of both work and learning opportunities across place and time. Clinical photographs were recognised as being against regulations but there had still been occasions of use despite this. Concerns about public and colleague perceptions were important to both students and doctors, with participants describing various tactics employed to successfully integrate phone use into their practices.ConclusionThis study suggests that both final year medical students and foundation trainees use smartphones in everyday practice. Medical schools and healthcare institutions should seek to integrate such use into core curricula/training to enable safe and effective use and further ease the transition to foundation training. We recommend juniors are reminded of the potential risks to patient confidentiality associated with smartphone use.
Highlights
The transition from medical student to junior doctor is one of the most challenging in medicine, affecting both doctor and patient health
We argue that our findings suggest that prescribing support, such as that provided through the MicroGuideTM app, are of great value to those transitioning from final year student to practising junior doctor, and could help improve graduate preparedness for the workplace
We would recommend that induction and placement shadowing include the issue of how best to use smartphones in the workplace. Taking the findings both from our study, and others [57, 58], we suggest trainees be reminded of the risk of breaching confidentiality through common smartphone uses such as instant messaging, photographs and even phone conversations
Summary
The transition from medical student to junior doctor is one of the most challenging in medicine, affecting both doctor and patient health. Despite the Shenouda et al BMC Medical Education (2018) 18:175 greater level of responsibility placed upon final year students, junior doctors still feel unprepared when it comes to decision making, prescribing, roles within the medical hierarchy and performing under stress [5,6,7]. This clinical uncertainty can translate into poor patient and treatment outcomes highlighting the importance of helping foundation trainees through this transition [4, 8]
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