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Table 1 Struggles experienced by the NGDs and contextual factors

From: Struggling to fit the white coat and the role of contextual factors within a hospital organisation - an ethnographic study on the first months as newly graduated doctors

Struggles

Newly Graduated Doctors’ experiences

(Observed and expressed)

Contextual factors

(Conceptualised by components of CHAT)

1. Responsibility

Overwhelmed by the sudden feeling of responsibility

Fearful of (potential) consequences

Difficulties and uncertainty in decision-making

Worsened when the NGDs worked physically remote from other doctors (division of labour)

The NGDs are by law not the ones responsible for the final decisions (rules)

2. Local knowhow

Local knowhow as a prerequisite for the NGDs’ work

Insufficient local knowhow affected the NGDs’ pace of work

The introduction period was time limited (rules), but with information overload (tools)

Often there was no overlap between new and more experienced NGDs (rules)

3. Time management

Lacking a sense of time made prioritising tasks difficult

Heavy workload generated stressful situations and missed learning opportunities (reflections)

Many interruptions

The NGDs often covered several departments at the same time (division of labour)

Guidelines caused numerous interruptions (rules)

4. Collaborators

Collaborators were crucial during the first months and were addressed differently

Collaborators could be challenging

The NGDs had many different departments and collaborators with various perspectives to relate to (division of labour)

The NGDs worked in the frontline, physically remote from their departments (division of labour)