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

ABSTRACT

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.