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Disciplinary boundaries and integrating care: using Q-methodology to understand trainee views on being a good doctor.
- Source :
- BMC Medical Education; 2/15/2019, Vol. 19 Issue 1, pN.PAG-N.PAG, 1p, 1 Diagram, 4 Charts
- Publication Year :
- 2019
-
Abstract
- Background: Rising numbers of patients with multiple-conditions and complex care needs mean that it is increasingly important for doctors from different specialty areas to work together, alongside other members of the multi-disciplinary team, to provide patient centred care. However, intra-professional boundaries and silos within the medical profession may challenge holistic approaches to patient care. Methods: We used Q methodology to examine how postgraduate trainees (n = 38) on a range of different specialty programmes in England and Wales could be grouped based on their rankings of 40 statements about 'being a good doctor'. Themes covered in the Q-set include: generalism (breadth) and specialism (depth), interdisciplinarity and multidisciplinary team working, patient-centredness, and managing complex care needs. Results: A by-person factor analysis enabled us to map distinct perspectives within our participant group (P-set). Despite high levels of overall commonality, three groups of trainees emerged, each with a clear perspective on being a good doctor. We describe the first group as 'generalists': team-players with a collegial and patient-centred approach to their role. The second group of 'general specialists' aspired to be specialists but with a generalist and patient-centred approach to care within their specialty area. Both these two groups can be contrasted to those in the third 'specialist' group, who had a more singular focus on how their specialty can help the patient. Conclusions: Whilst distinct, the priorities and values of trainees in this study share some important aspects. The results of our Q-sort analysis suggest that it may be helpful to understand the relationship between generalism and specialism as less of a dichotomy and more of a continuum that transcends primary and secondary care settings. A nuanced understanding of trainee views on being a good doctor, across different specialties, may help us to bridge gaps and foster interdisciplinary working. [ABSTRACT FROM AUTHOR]
- Subjects :
- MEDICINE
PHYSICIANS
GEOGRAPHIC boundaries
PRIMARY care
Subjects
Details
- Language :
- English
- ISSN :
- 14726920
- Volume :
- 19
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- BMC Medical Education
- Publication Type :
- Academic Journal
- Accession number :
- 134753695
- Full Text :
- https://doi.org/10.1186/s12909-019-1493-2