Transition processes through a longitudinal integrated clerkship: a qualitative study of medical students' experiences.

CONTEXT: This paper describes the transition processes experienced by Year 3 medical students during their longitudinal integrated clerkship (LIC). The authors conceptualise the stages that encompass the transition through a LIC. OBJECTIVES: The purpose of this study was to understand the perspectives of 12 Northern Ontario School of Medicine (NOSM) Year 3 medical students about their transition process. METHODS: Data were collected longitudinally through three conversational interviews with each of these students, occurring before, during and after the clerkship. The authors used a guided walk methodology to explore students' everyday lives and elicit insights about the transition process, prompted by the locations and clinical settings in which the clerkship occurred. RESULTS: Participants identified three interconnected stages in the transition process: (i) shifting from classroom to clinical learning; (ii) dealing with disorientation and restoring balance, and (iii) seeing oneself as a physician. Interview data provided evidence for the adaptive strategies the participants developed in response to these stages. CONCLUSIONS: Based on these findings, the transition process during a LIC can be characterised as one of entering the unfamiliar, with few forewarnings about the changes, of experiencing moments of confusion and burnout, and of eventual gains in confidence and competence in the clinical roles of a physician. Recommendations are made regarding future research opportunities to further scholarship on transitions.

Interviewing in situ: employing the guided walk as a dynamic form of qualitative inquiry.

CONTEXT: The purpose of this paper is to provide a critical analysis of a mobile research method, the guided walk, and its potential suitability in medical education research. METHODS: The Northern Ontario School of Medicine's (NOSM) longitudinal integrated clerkship served as the research context in which the guided walk method was used to explore the lived experiences of 12 Year 3 medical students undertaking their clerkship in one of eight different communities across Northern Ontario, Canada. Informed by the social constructivist research paradigm, the guided walk method was employed to answer the research question: how do Year 3 medical students at NOSM describe their clerkship experiences as encountered in their placement and living contexts? Through an inductive thematic analysis of the data, the findings provided a rich description of the guided walk from the participants' and the researcher's perspectives. RESULTS: There were significant advantages to using the guided walk rather than other types of qualitative research approaches. The guided walk made it easier for participants to take part in the study, provided context-rich research interactions, and led to serendipitous encounters for both participants and the first author. There were also challenges and limitations associated with the guided walk method. For example, this method carries inherent challenges with reference to the safeguarding of confidentiality and anonymity for both participants and those encountered during the walk. CONCLUSIONS: The guided walk method is promising within medical education, particularly for researchers seeking to gain participants' stories in the contexts to which they refer. This method may be appropriate for use in medical education research in areas such as the evaluation and assessment of a student's clinical decision-making skills and competency development, as well as the consolidation of strategies to manage ethical and professional dilemmas.

The social support experiences of major junior ice hockey players in a physically removed region of Canada.

The present report from a larger project overviews the sources and types of social support resourced by 10 major junior athletes while they performed out of one physically removed Canadian region. Retrospective interviews and content analysis were conducted during three stages (3, 3, and 4 respondents). The data were segmented into meaning units, coded into a hierarchy of themes, and verified by each respondent and an expert panel (former athlete, coach, parent of former athlete). The respondents sought out three types of social support from four different sources (providers) that were adapted to their remote location, including teachers and general community support. Implications are considered in terms of applied research and practice with aspiring adolescent athletes located in removed locations. Key pointsThe study extends knowledge about the sources and types of social support resourced by elite major junior ice hockey players located in one physically removed Canadian region.From the respondents' views, three types of social support were sought from four different sources.Implications are considered in terms of sport psychology research and applied practice.