The transition to hospital consultant: Denmark and the Netherlands compared on preparedness for practice, perceived intensity and contextual factors

Introduction: Danish and Dutch new consultants’ perceptions regarding the transition to consultant were compared to gain insight into this period, particularly the influence of contextual factors concerning the organisation of specialty training and health care therein. Preparation for medical and generic competencies, perceived intensity and burnout were compared. Additionally, effects of differences in working conditions and cultural dimensions were explored. Methods: All consultants registered in the Netherlands in 2007–2009 (n = 2643) and Denmark in 2007–2010 (n = 1336) received in June 2010 and April 2011, respectively, a survey about their preparation for medical and generic competencies, perceived intensity and burnout. Power analysis resulted in required sample sizes of 542. Descriptive statistics and independent t-tests were used for analysis. Results: Data were available of 792 new consultants in the Netherlands and 677 Danish new consultants. Compared to their Dutch counterparts, Danish consultants perceived specialty training and the transition less intensely, reported higher levels of preparation for generic competencies and scored lower on burnout. Conclusions: The importance of contextual aspects in the transition is underscored and shows that Denmark appears to succeed better in aligning training with practice. Regulations regarding working hours and progressive independence of trainees appear to facilitate the transition.

[1]  A. Scherpbier,et al.  The transition to hospital consultant and the influence of preparedness, social support, and perception: A structural equation modelling approach , 2013, Medical teacher.

[2]  P. Teunissen,et al.  Junior doctors caught in the clash: the transition from learning to working explored , 2011, Medical education.

[3]  H. Cameron,et al.  Understanding the behaviour of newly qualified doctors in acute care contexts , 2011, Medical education.

[4]  P. Teunissen,et al.  Opportunity or threat: the ambiguity of the consequences of transitions in medical education , 2011, Medical education.

[5]  Cees P M van der Vleuten,et al.  Understanding the Transition From Resident to Attending Physician: A Transdisciplinary, Qualitative Study , 2010, Academic medicine : journal of the Association of American Medical Colleges.

[6]  J. Freischlag,et al.  Surgeon distress as calibrated by hours worked and nights on call. , 2010, Journal of the American College of Surgeons.

[7]  M. Jippes,et al.  Influence of national culture on the adoption of integrated medical curricula , 2010, Advances in health sciences education : theory and practice.

[8]  M P Schijven,et al.  Transatlantic comparison of the competence of surgeons at the start of their professional career , 2010, The British journal of surgery.

[9]  T. Wilkinson,et al.  Maximising learning through effective supervision. , 2010, The New Zealand medical journal.

[10]  Fedde Scheele,et al.  Assessment of competence and progressive independence in postgraduate clinical training , 2009, Medical education.

[11]  N. Shaw,et al.  Working as a newly appointed consultant: a study into the transition from specialist registrar. , 2009, British journal of hospital medicine.

[12]  B. Burford,et al.  Are specialist registrars fully prepared for the role of consultant? , 2009 .

[13]  C. Ringsted,et al.  Evaluation of a national process of reforming curricula in postgraduate medical education , 2009, Medical teacher.

[14]  T. Dornan,et al.  Maturity and medical students’ ease of transition into the clinical environment , 2009, Medical teacher.

[15]  Anthony P S Guerrero Navigating Problem-based Learning by Samy Azer, Sydney, Australia, Elsevier, 2008, 221 p., ISBN 978 0 7295 3827 (pbk.) , 2009 .

[16]  Glenn Regehr,et al.  "I'll never play professional football" and other fallacies of self-assessment. , 2008, The Journal of continuing education in the health professions.

[17]  H. Schmidt,et al.  Description, justification and clarification: a framework for classifying the purposes of research in medical education , 2008, Medical education.

[18]  P. Teunissen,et al.  Introducing competency-based postgraduate medical education in the Netherlands , 2008, Medical teacher.

[19]  Fedde Scheele,et al.  Viewpoint: Competency-Based Postgraduate Training: Can We Bridge the Gap between Theory and Clinical Practice? , 2007 .

[20]  Edgar Erdfelder,et al.  G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences , 2007, Behavior research methods.

[21]  Rodney A. Hayward,et al.  Predictors of Physician Career Satisfaction, Work–Life Balance, and Burnout , 2007, Obstetrics and gynecology.

[22]  T. Habermann,et al.  Association of perceived medical errors with resident distress and empathy: a prospective longitudinal study. , 2006, JAMA.

[23]  Henk G Schmidt,et al.  Longterm effects of problem‐based learning: a comparison of competencies acquired by graduates of a problem‐based and a conventional medical school , 2006, Medical education.

[24]  R. Brown,et al.  The new consultant survey 2005 , 2006, Emergency Medicine Journal.

[25]  G. Regehr,et al.  Progressive Independence in Clinical Training: A Tradition Worth Defending? , 2005, Academic medicine : journal of the Association of American Medical Colleges.

[26]  L. McMahon,et al.  Effects of work hour reduction on residents' lives: a systematic review. , 2005, JAMA.

[27]  C. Ringsted,et al.  A pilot survey of junior doctors’ confidence in tasks related to broad aspects of competence , 2005, Medical teacher.

[28]  J. Rutherford,et al.  From specialist registrar to consultant: permission to land? , 2005 .

[29]  D. Gallen,et al.  Meeting the non-clinical education and training needs of new consultants , 2005, Postgraduate Medical Journal.

[30]  A. Scherpbier,et al.  Students' opinions about their preparation for clinical practice , 2005, Medical education.

[31]  M. Charap Reducing Resident Work Hours: Unproven Assumptions and Unforeseen Outcomes , 2004, Annals of Internal Medicine.

[32]  Klaas Sijtsma,et al.  Investigation and Treatment of Missing Item Scores in Test and Questionnaire Data , 2003, Multivariate behavioral research.

[33]  R. Steinbrook,et al.  The debate over residents' work hours. , 2002, The New England journal of medicine.

[34]  R. Bhagat Culture's Consequences: Comparing Values, Behaviors, Institutions, and Organizations Across Nations , 2002 .

[35]  Tait Shanafelt,et al.  Burnout and Self-Reported Patient Care in an Internal Medicine Residency Program , 2002, Annals of Internal Medicine.

[36]  G. Hofstede,et al.  Culture′s Consequences: International Differences in Work-Related Values , 1980 .

[37]  D. Dolmans,et al.  Preparation for practice by veterinary school: a comparison of the perceptions of alumni from a traditional and an innovative veterinary curriculum. , 2008, Journal of veterinary medical education.

[38]  Fedde Scheele,et al.  Competency-based postgraduate training: can we bridge the gap between theory and clinical practice? , 2007, Academic medicine : journal of the Association of American Medical Colleges.

[39]  S. Kite,et al.  Transition from SpR to consultant: a survey of training needs in palliative medicine. , 2006, Palliative medicine.

[40]  R. Groves Nonresponse Rates and Nonresponse Bias in Household Surveys , 2006 .

[41]  C. Meng Discipline-Specific or Academic? Acquisition, Role and Value of Higher Education Competencies , 2006 .

[42]  J. Semeijn Academic competences and labour market entry : studies among Dutch graduates , 2005 .

[43]  R. Crausman Residents' work hours. , 2003, The New England journal of medicine.

[44]  C. Cooper,et al.  On the move : the psychology of change and transition , 1990 .