“That’s your patient. There’s your ventilator- exploring induction to work experiences in a group of non-UK EEA trained anaesthetists in a London hospital: a qualitative study

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• 作者：Huon Snelgrove ; Yuriy Kuybida ; Mark Fleet ; Greg McAnulty
• 关键词：Continuing education ; International medical graduates ; Anaesthetists ; Critical care ; Induction to work ; Acclimatisation ; Safety orientation ; Practice ; based learning ; Socio ; cultural theory
• 刊名：BMC Medical Education
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：15
• 期：1
• 全文大小：481 KB
• 参考文献：1. Goddard, AF (2011) Progress on the European Working Time Directive (EWTD) and new deal negotiations. Clin Med 11: pp. 420-1 CrossRef
  2. Ilangaratne, J (2011) Impact of reduced working hours. Fundamental purpose of EWTD. BMJ 342: pp. d2421 CrossRef
  3. General Medical Council: The state of Medical education and Practice in the UK. Available at: uk.org/publications/23435.asp" class="a-plus-plus">http://www.gmc-uk.org/publications/23435.asp Accessed 15/06/2014. In / .; 2013.
  4. French, F, Ikenwilo, D, Scott, A (2006) What influences the job satisfaction of staff and associate specialist hospital doctors?. Health Serv Manage Res 20: pp. 153-61 CrossRef
  5. Dornhorst, A, Cripps, J, Goodyear, H, Marshall, J, Waters, E, Boddy, S (2004) Improving hospital doctors-working lives: online questionnaire survey of all grades. Postgrad Med 81: pp. 49-54 CrossRef
  6. Groutsis, D, Arnold, P (2012) Tracking the career decisions and experince of migrant elites: the case of South African-trained medical professionals in the Australian labour market. Health Sociol Rev 21: pp. 332-42 CrossRef
  7. Curran, V, Hollett, A, Hann, S, Bradbury, C (2008) A qualitative study of the international medical graduate and the orientation process. Can J Rural Med 13: pp. 163-9
  8. Hall, P, Keely, E, Dojeiji, S, Byszewski, A, Marks, M (2004) Communication skills, cultural challenges and individual support: challenges of international medical graduates in a Canadian healthcare environment. Med Teach 26: pp. 120-5 CrossRef
  9. Slowther, A, Lewando Hundt, GA, Purkis, J, Taylor, R (2012) Experiences of non-UK-qualified doctors working within the UK regulatory framework: a qualitative study. J R Soc Med 105: pp. 157-65 CrossRef
  10. Zulla, R, Baerlocher, MO, Verma, S (2008) International medical graduates (IMGs) needs assessment study: comparison between current IMG trainees and program directors. BMC Med Educ 8: pp. 42 CrossRef
  11. Kales, HC, DiNardo, AR, Blow, FC, McCarthy, JF, Ignacio, RV, Riba, MB (2006) International medical graduates and the diagnosis and treatment of late-life depression. Acad Med 81: pp. 171-5 CrossRef
  12. Searight, HR, Gafford, J (2006) Behavioral science education and the international medical graduate. Acad Med 81: pp. 164-70 CrossRef
  13. Pilotto, LS, Duncan, GF, Anderson-Wurf, J (2007) Issues for clinicians training international medical graduates: a systematic review. Med J Aust 187: pp. 225-8
  14. Harris, A, Delany, C (2013) International medical graduates in transition. Clin Teach 10: pp. 328-32 CrossRef
  15. Sawchuk, PH (2013) Contested Learning in Welfare Work; A study of Mind, Political Economy, and the Labour Process. Cambridge University Press, Cambridge CrossRef
  16. Kilminster, S, Zukas, M, Quinton, N, Roberts, T (2011) Preparedness is not enough: understanding transitions as critically intensive learning periods. Med Educ 45: pp. 1006-15 CrossRef
  17. Wickford, J, Rosberg, S (2011) From idealistic helper to enterprising learner: critical reflections on personal development through experinces from Afghanistan. Physiother Theory Pract 28: pp. 283-91 CrossRef
  18. Newton, J, Henderson, A, Jolly, B (2015) A contemporary examin
• 刊物主题：Medical Education; Theory of Medicine/Bioethics;
• 出版者：BioMed Central
• ISSN：1472-6920

文摘

Background European health systems depend increasingly on the services of health professionals who obtained their primary medical qualification from other countries. There has been a significant increase recently in fully qualified specialist doctors arriving from the European Union to provide short term or longer-term solutions to health human resources needs in the UK National Health System. These doctors often take up senior consultant positions. As a result, the NHS has had to learn to deal with both expatriation and repatriation of EU doctors as a constant dynamic characteristic of its own ability to deliver services. We conducted a qualitative study to explore the acclimatisation experience of EU doctors with qualifications in anaesthesia arriving in the United Kingdom to take up clinical employment in the NHS. The question we ask is: how do specialty registered anaesthetists who trained in other European countries experience the process of acclimatisation to practice in the United Kingdom in a large hospital in London? Methods We did individual interviews with non-UK, EU-qualified doctors with Certification of Completion of specialty Training who were registered with the General Medical Council in the UK and could practice in the NHS as specialist anaesthetists. The doctors were all interviewed whilst working in a large NHS teaching hospital in London, UK. We analysed qualitative data from interview transcripts to identity themes and patterns regarding senior doctor’s acclimatisation to the British system. Results Acclimatisation conceived of as transfer of clinical expertise was problematic for doctors who felt they lacked the right kind of support. Doctors sought different opportunities to share wider perspectives on care deriving from their previous experience. Conclusions Hospital conceptions of acclimatisation as a highly individual process can offer an idealized view of clinical work and learning in the new system. Socio-cultural theories suggest we create regular learning opportunities for international staff to critically reflect on practice with local staff to acclimatise more effectively.