Perspectives des médecins de famille en début de carrière sur leur expérience de résidence et leurs choix de pratique au Canada : une étude qualitative
DOI :
https://doi.org/10.36834/cmej.78363Résumé
Contexte : Bien qu'il y ait plus de médecins de famille au Canada que jamais auparavant et que les programmes de résidence continuent de se développer, des lacunes subsistent dans l'accès aux soins globaux. Cette étude visait à décrire et à comprendre le rôle que les expériences de formation en résidence ont joué dans l’orientation des choix de pratique, incluant la prestation de soins communautaires complets, parmi les médecins de famille en début de carrière.
Méthodes : Une analyse secondaire de soixante-trois (63) entrevues qualitatives a été effectuée sur les données d'une étude plus vaste à méthodes mixtes sur les modes et les choix de pratique des médecins de famille canadiens en début de carrière. Nous avons utilisé les six phases de l'analyse thématique réflexive de Braun et Clarke pour analyser les sections des transcriptions portant sur les expériences de formation en résidence.
Résultats : Les participants ont décrit des expériences positives de formation en résidence qui ont façonné leur choix de pratique en ce qui concerne les précepteurs et le mentorat, les expériences de soins longitudinaux, l'étendue de l'exposition et la préparation à la pratique clinique globale. Des « points de tension » et des « vérités cachées » sont apparus dans ces quatre domaines. Les points de tension comprenaient : i) la promotion d'une identité et d'une pratique professionnelles idéalisées qui étaient difficiles à maintenir, ii) le manque de représentation parmi les professeurs/précepteurs en ce qui concerne l'âge et le sexe, dans certains lieux, et iii) la frustration concernant le manque d'occasions de pratiques de collaboration interprofessionnelle qui reflétaient les expériences de formation. Les vérités cachées comprenaient : i) le manque de préparation à la gestion d'une entreprise, ii) la charge de travail administrative élevée, iii) les réalités des modèles de paiement, et iv) l'éventail des rôles disponibles pour les médecins de famille au-delà de la prestation de soins globaux.
Conclusions : Les résultats mettent en évidence les possibilités de réforme de l'enseignement pour soutenir la transition entre la résidence et la pratique, ainsi que l'importance d'aborder les facteurs systémiques au-delà de la formation qui ont un impact sur les choix des médecins en matière de soins globaux.
Statistiques
Références
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(c) Tous droits réservés Catherine Moravac, Agnes Grudniewicz, Ian Scott, Ellen Randall, Laurie J Goldsmith, Emily G Marshall, Lori Jones, M Ruth Lavergne 2023
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