Overarching Themes


Description of Subthemes


1.0: Real world issues for the student transitioning to doctor

1.1: Procedural and patient consent dilemmas

The clinical skills tasks that a junior doctor commonly does at the patient’s bedside and consent for these

“I started off as I say in surgery and wouldn’t even have half a clue what the procedures were like.”

(Interview 5, Male, mid-twenties)

1.2: Competence in resuscitation

The activity that takes place after a cardiac arrest

“You know the steps that were taken, you know, in the ACLS algorithm, but I was never involved in any decision making myself, you know, you try and get your line in …”

(Interview 7, Male, mid-twenties)

1.3: Ethics from the frontline as a new doctor

Decision making and how these decisions are made form a new doctors viewpoint

“We actually had one night where we had two arrests here at the same time, in two rooms next to each other, and then that was a total (pause) ... there are a lot of people… where you are probably putting through a lot of, you know, people that really shouldn’t be resuscitated.”

(Interview 5, Male, mid-twenties)

1.4: Patient safety and preparedness for work

The levels of preparedness that doctors feel they have in dealing with patients safely

“(Clinical Skills task) People get frustrated and the more frustrated people get, the more panicky you get, then the whole things a disaster, where in truth, it could be someone fairly sick.”

(Interview 9, Male, mid-twenties)

2.0: Ward Life and how it impacts on performance

2.1: Practicalities of ward life

The day to day office and administration of a ward/hospital

“Other things are like logistical things… like ordering stuff. The fact that as an intern you very much a paper pusher and organiser and I think if you’re not determined to get something done yourself, then a lot of the jobs can be left or pushed back and I think that can affect the overall working of the whole hospital.”

(Interview 8, Female, mid-twenties)

2.2: After dark (on-call)

The period of time after 6 PM until morning when the hospital runs on a skeleton staff and junior staff are much more exposed to clinical care scenarios

“Sometimes it really clear, I remember getting a phone call on a bad call, two patients with early warning scores of seven and one patient who was confused with a blood sugar of one, so you can automatically go, oh well this decision is made for me here, but other times when you run around, and you are like kind of oh, and when you are really busy it can be difficult to decide.”

(Interview 6, Female, mid-twenties)