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Table 5 Making sense of how they became prepared

From: A qualitative analysis of junior doctors’ journeys to preparedness in acute care

CategoriesThemesNumber of codes (number of respondents)Example quotes
Why experiential learning mattersVolume is essential19 (7)“What is expected of me as an F1? I feel like I’ve got that down for sure, but it required multiple difficult weekends and night-shifts to really get that balance… The hands-on experience, that being put in the moment and being put on the spot and under pressure for me, was the biggest, biggest learning experience.” (Respondent G)
Observing more experienced healthcare professionals12 (6)“There are certain things that you will pick up from some medical registrars or medical SHOs in the way that you [think], “I really like how you did that, I will try and incorporate that into my practise”.” (Respondent C)
Taking responsibility for decisions9 (3)“You take no responsibility at medical school, you are not forced to make decisions... I did observe people assessing acutely unwell [patients] but was never forced to think myself which is probably the harder thing.” (Respondent E)
Why reflection mattersUseful learning through reflection with colleagues3 (3)“I think the form of reflection I find the most useful is actually just debriefing or talking to a colleague… I just find that kind of instant feedback that you get with talking it out with someone you trust is really like way more valuable.” (Respondent B)
Useful learning through self-reflection5 (2)“I think reflecting albeit just in your own head, not necessarily formally, is essential. Because you cannot change what you have done previously if you don’t reflect.” (Respondent E)
Experiences of simulationSimulation doesn’t reflect the uncertainty of real-world10 (4)“[Simulation] doesn’t take into account the uncertainty that you get sometimes. So, that’s why a simulation feels sometimes feels quite an artificial environment.” (Respondent C)
Useful for learning to think under pressure4 (3)“[Simulation] actually got you thinking outside of just what’s in front of you and how you treated the team that you are dealing with.” (Respondent F)
Minor themes: Useful for learning about MDT More useful as F1 when aware of responsibilities Feedback is on best self rather than true behaviour“Yeah, yeah, I think that would be really helpful actually having a nurse and HCA there because then you can get to know what their competencies are... And understand what their respective roles are.” (Respondent C)
Experiences of undergraduate learning opportunitiesUseful shadowing junior doctors and emergency response teams9 (4)“But I think probably the most useful thing would be when you are later on in medical school to be like partnered with an F1 or F2 on-call. And either just observe or where it’s appropriate be like exposed to doing a bit of initial assessment.” (Respondent E)
Teaching too theoretical, interested in practicalities of acute care10 (4)“So I think we’re often given the bog-standard cases in medical school, so you’re looking from a textbook, science book, sometimes patients don’t present with the textbook signs.” (Respondent A)
Useful when final year aligns with preparing for F16 (4)“I think that med school can incorporate all of their knowledge within four years... And the fifth year should be something [where] you prepare yourselves for F1.” (Respondent F)
Minor themes: No experience of decision making as student Need proactive seniors Lack of continuity in acute care experiences Desire for more MDT learning together“...I think the one shame is in medical school and probably in F1, there isn’t more MDT learning together.” (Respondent C)