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Table 3 Identified barriers and proposed strategies

From: Exploring the factors that affect the transition from student to health professional: an Integrative review

Barriers

Strategies/Facilitators

Systems and structures

1. Complex workplace systems: Complex hierarchies, administrative processes workplace politics and organisational dynamics [4, 6, 14, 16, 33, 36].

2. Stereotyped operational cultures [15, 17]

3. Complex and overwhelming work-related responsibilities [3, 4, 15, 28, 34]..

4. Unrealistically high expectations [3, 13, 25, 26, 29].

5. Lack of recognition and respect [5, 17, 29, 30, 33]

1. Sufficient orientation programmes [11, 13, 16, 31, 32].

2. Preceptorship programmes [13, 28, 31].

3. Mentoring programmes [5, 16, 22].

4. Support from experienced senior colleagues [4, 5, 11, 16, 23, 30, 31].

5. Peer group [4].

6. Constructive feedback on performance from seniors, colleagues and clients [32, 34].

7. Effective supervision [6, 7, 11, 13].

Personal capacities

1. Reduced perception of self-competence and unreadiness for practice [4, 6, 7, 18,19,20,21,22, 26, 27, 31,32,33].

2. Overwhelming feeling of inadequacy [5, 7, 23, 29]

3. Reduced self-confidence [4, 10, 11, 17, 21, 22, 24, 32]

1. Excitement in acquiring new skills and growing in their professions [3, 5].

2. Motivation by associating their role to spiritual benefits [17].

Professional competences

1. Disparity between academics and actual practice [3, 4, 16, 21, 29].

2. High levels of tension, anxiety and nervousness upon entering the world of practice [6, 7, 20, 25,26,27, 29, 32, 33].

3. Inability to manage stressful emotional work-related situations [13, 20, 23].

4. Role confusion [6, 13, 29]

5. Inadequacy in clinical practice skills such as communication skills [10, 22, 24], organisational and management skills [16, 22], clinical decision-making skills [5, 22] and skills required for specific practice areas [6, 16, 29].

6. Insufficient practical and clinical exposure in training [4,5,6, 21].

1. Prior clinical placement experiences helps ameliorate the stress and uncertainties that characterised transition into practice [4, 5, 7, 24].

2. Cultivating a ‘doing, not observing’ attitude during transition into practice [26].

Mediating processes (Strategies/Facilitators for this theme apply to all three themes above)

 

1. Recognition that competence comes through continuous learning [7, 17, 33]. Through

a. Personal reading [4, 22].

b. Revisiting lecture notes [4].

c. Taking continuing education courses [6].

d. Learning from the mistakes they make [25]

e. Creating informal learning culture together with peers [36]

f. Observing and learning from experienced senior colleagues [25].

2. Establishing supportive contacts [4, 6, 11, 16,17,18, 23, 25, 31]. Through:

a. Peer support meetings [5, 25],

b. Study groups [5],

c. Networking [6, 17]

d. Peer debriefing sessions [5, 22].

e. Previous lecturers [4],

f. Senior colleagues [5, 6]

g. Fellow health professionals [7, 17, 30].

3. Meaningful personal and social lives help alleviate transition stressors [17, 29, 30].

4. healthy intra and interprofessional relationship [28, 30].

5. Asking for help when uncertain [4, 6, 36].

6. Seeking remote mentors and coaches [6].

7. Effective listening and regularly asking questions [4, 22].

8. Effective time management [6, 7].