Beyond the struggles : using social-developmental lenses on the transition to clinical training

Abstract

Transitions are inevitable. Transition discourse often focuses on the stress associated with entering a new phase of training. Medical educators and researchers have sought to eliminate transition stress with limited success. Recent transition literature has called for new perspectives on the transition 'problem' to optimise students' adaptation to change. This thesis aimed to enhance our understanding of how undergraduate medical students navigate the transition from pre-clinical to clinical training using sociocultural lenses. We first conducted a scoping review (Chapter Two) exploring how researchers have approached the transition from pre-clinical to clinical training and identified the gaps in these approaches. Following the scoping review, we created two overarching questions that address to our research agenda. 1) In what ways does the transition from pre-clinical to clinical training contribute to medical students' professional and personal identity development? 2) What role do social relationships play in students' transition from pre-clinical to clinical training? Chapters Three through Five represent individual empirical studies and publications each conducted within the five-year Bachelor of Medicine, Bachelor of Surgery (MBBS) undergraduate medical programme at Western Sydney University in Australia between 2018 and 2020. We conclude that the transition to clinical training is an opportunity for student identity and lifelong skill development (e.g. proactive behaviour); our explicit consideration of identity formation shows this. It occurs when students went from being pre-clinical students to becoming clinical students working and learning around patients. We also conclude that the transition to clinical training is an opportunity for students' social network development and utilisation. We found that students' networks are diverse- including family, peers, near-peers, doctors, academic staff, nurses; dynamic-they change significantly over time; and deliberate-students made choices about who was in their social support networks. We lastly conclude that the transition to clinical training is both a threat and an opportunity for learning and development; a developmental networking asset. Students' lived reality of this tension between opportunity and threat will depend on educators shifting their transition-related perspectives, and creating supportive environments for the transitioning student.

Date of Award	2021
Original language	English