Evidence map›Paper›PMID 28087554›Full record

ReviewBMJ open2017

How prepared are UK medical graduates for practice? A rapid review of the literature 2009-2014.

Lynn V Monrouxe, Lisa Grundy, Mala Mann, Zoe John, Eleni Panagoulas, Alison Bullock, Karen Mattick

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 127 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
127citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

127 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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67 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Lynn V MonrouxeChang Gung Medical Education Research Centre (CG-MERC), Chang Gung Memorial Hospital, Taoyuan City, Taiwan.ORCID 0000-0002-4895-1812
Lisa GrundyAberdeen Royal Infirmary, Aberdeen, UK.
Mala MannCardiff University Library Service, Cardiff, Wales, UK.
Zoe JohnSchool of Social Sciences, Cardiff University, Cardiff, Wales, UK.
Eleni PanagoulasCardiff University, Cardiff, Wales, UK.
Alison BullockCUREMeDE, Cardiff University School of Social Sciences, Cardiff, Wales, UK.
Karen MattickCentre for Research in Professional Learning, Graduate School of Education, University of Exeter, Exeter, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo understand how prepared UK medical graduates are for practice and the effectiveness of workplace transition interventions.

designA rapid review of the literature (registration #CRD42013005305). DATA SOURCES: Nine major databases (and key websites) were searched in two timeframes (July-September 2013; updated May-June 2014): CINAHL, Embase, Educational Resources Information Centre, Health Management Information Consortium, MEDLINE, MEDLINE in Process, PsycINFO, Scopus and Web of Knowledge. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Primary research or studies reporting UK medical graduates' preparedness between 2009 and 2014: manuscripts in English; all study types; participants who are final-year medical students, medical graduates, clinical educators, patients or NHS employers and all outcome measures. DATA EXTRACTION: At time 1, three researchers screened manuscripts (for duplicates, exclusion/inclusion criteria and quality). Remaining 81 manuscripts were coded. At time 2, one researcher repeated the process for 2013-2014 (adding six manuscripts). Data were analysed using a narrative synthesis and mapped against Tomorrow's Doctors (2009) graduate outcomes.

resultsMost studies comprised junior doctors' self-reports (65/87, 75%), few defined preparedness and a programmatic approach was lacking. Six themes were highlighted: individual skills/knowledge, interactional competence, systemic/technological competence, personal preparedness, demographic factors and transitional interventions. Graduates appear prepared for history taking, physical examinations and some clinical skills, but unprepared for other aspects, including prescribing, clinical reasoning/diagnoses, emergency management, multidisciplinary team-working, handover, error/safety incidents, understanding ethical/legal issues and ward environment familiarity. Shadowing and induction smooth transition into practice, but there is a paucity of evidence around assistantship efficacy.

conclusionsEducational interventions are needed to address areas of unpreparedness (eg, multidisciplinary team-working, prescribing and clinical reasoning). Future research in areas we are unsure about should adopt a programmatic and rigorous approach, with clear definitions of preparedness, multiple stakeholder perspectives along with multisite and longitudinal research designs to achieve a joined-up, systematic, approach to understanding future educational requirements for junior doctors.

Indexed as

Attitude of Health PersonnelClinical CompetenceCurriculumEducational MeasurementEducation, MedicalHumansInternship and ResidencyQualitative ResearchSelf ReportSurveys and QuestionnairesUnited KingdomBASIC SCIENCESEDUCATION & TRAINING (see Medical Education & Training)GENERAL MEDICINE (see Internal Medicine)INTENSIVE & CRITICAL CARE

Identifiers

PMID28087554
PMCPMC5253586

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.