gms | German Medical Science

Introduction: As medical schools cannot prepare junior doctors for every aspect of their professional clinical work [1], junior doctors have to acquire the "tacit knowledge" necessary to show efficient performance through engaging in the social context of work [2]. However, little has been published on how junior doctors actually learn in the clinical workplace [3].

Methods: An interview-study with N=9 internal medicine specialists (8 to 35 years of clinical experience) in rural and university hospitals in southern Germany was conducted in 2014 to assess the specialists’ perspective on junior doctors’ learning at the workplace. Eraut’s model of early career learning [4] and Teunissen et al.’s framework of residents learning in the workplace [5] informed the development of the interview guide. A literature based coding-scheme was used in an inductive-deductive approach to analyse the data.

Results: We identified social relations in the workplace, personal knowledge and the structure of work as factors related to junior doctors’ learning in the workplace. Preconditions for interaction (e.g. availability of interaction-partners, fear-free environment), content of interaction (e.g. advice, feedback, support) and status of interaction-partner (e.g. superior, peer, nursing-staff) emerged as sub-categories within the theme of social interaction. The results suggest that different contacts relate to different learning needs. They help junior doctors to set their experiences with clinical activities into perspective and facilitate their professional development.

Discussion: In order to foster clinical performance, the social integration of junior doctors and their interaction partners at the clinical workplace needs to be better understood. A social network analysis approach might be helpful to broaden the insight.