CRPL Research Seminar - Dr Michelle Lazarus (Monash University) & Professor Lynn Monrouxe (Chang Gung Medical Education Research Centre (CG-MERC))

Dr Michelle Lazarus, Department of Anatomy & Developmental Biology, Monash University

Title:  Anatomy of Professional Role Development

Summary:  The role of basic sciences in healthcare education is often fraught with controversy.  Anatomy, in particular, has a long and sordid relationship with healthcare education curricula; strong opinions about how much time should be devoted to anatomy and when anatomy should be taught are oft debated, but rarely conclusively determined.  The discussions around anatomy also extend into how it should it be taught (with or without donor dissection) and who should be teaching it (clinical faculty or basic scientists), again without any definitive answers.   In recent years, there is additional increased pressure on anatomy education as contact hours drop, often in favour of students need for increased clinical exposure and clinical skill practice opportunities.  This seminar will explore, using anatomy as an archetypal basic science, an emerging question in the healthcare education field:  Is there a real or perceived dichotomy between basic science teaching (anatomy) and clinical skill preparation? Can we teach healthcare professional identity/professional role development within basic science coursework, or must one be sacrificed for the benefit of the other?  Using the qualitative method of Framework analysis on longitudinal open-ended question sampling of students enrolled in physiotherapy and medical anatomy, we begin to address these critical and pivotal questions:  Can we imbue basic science coursework with professional identity paradigms without sacrificing content for context?

Professor Lynn Monrouxe, Chang Gung Medical Education Research Centre (CG-MERC), Chang Gung Memorial Hospital 

Title: Smoothing transitioning into practice: the effect of aligned and misaligned work based placements

Summary: The transition into any professional occupation, and the immediate few years following, are difficult (Ewing & Manuel, 2005; Hinds, Williamson, & Gardner, 2011). During this transition, high-pressured work, long working hours, newly felt responsibilities and the reality of the job (versus idealised notions) interact with one another resulting in anxiety, stress, burnout and high attrition rates (Macdonald, 1999; Plunkett & Dyson, 2011; Friedman, 2000; Kumar, 2016). In the UK, the General Medical Council has recently introduced a compulsory new addition to the undergraduate medical curricula in the form a work-based transitional intervention (General Medical Council, 2009). The intervention is called the assistantship programme. Student assistantships are defined as placements in which final year medical students  “act as assistant to a junior doctor, undertaking defined duties under appropriate supervision” (General Medical Council, 2011). They are designed to address preparedness for practice concerns and the peak in patient safety-related incidences as final year students transition into becoming junior doctors (interns: Bates, 2011; Jones, Okeke, Bullock, Wells & Monrouxe, 2016; Vaughan, McAlister & Bell, 2011). Thus they comprise end-of-course work-based experiences with the specific aim of smoothing students’ transition into practice. 

Lynn and her colleagues have recently finished collecting data for their longitudinal programme of research aimed at understanding whether aligning (versus misaligning) this final work based placement with the students’ first post in practice has any effect on medical trainees’ transition into practice. They have examined participants’ transition experiences over a one-year period both qualitatively (through longitudinal individual and group narrative interviews with students/trainees and their supervisors) and quantitatively via an online questionnaire (including a Professional Identity Scale, a Team Understanding Scale, a Cognitive Flexibility Scale, the Hamilton Anxiety Rating Scale and the Copenhagen Burnout Inventory: Brown, Condor, Mathews, Wade & Williams, 1986; Hamilton, 1959; Kristensen, Borritz, Villadsen & Christensen, 2005; Adams, Hean, Sturgis & Clark 2006; Martin & Rubin, 1995). Although data analysis is still ongoing, Lynn will share with you their findings to date in order to open up a discussion around whether aligning final work based placements with trainees’ first job can help smooth the transition into practice for healthcare professionals as well as for professions out with medicine.