title: The impact of various transitions in the medical education continuum on perceived readiness of trainees to be entrusted with professional tasks.
abstract: BACKGROUND
  Medical trainees go through various transitions during the medical education continuum.
  
  
  OBJECTIVE
  The aim of this study was to understand how transitions in licensure and increased responsibility may affect trainees' competence development.
  
  
  METHODS
  We carried out a questionnaire study in Leeds (UK). Trainees and supervisors were asked to determine the trainee's competence at different stages of training to carry out a diversity of medical activities on a five-point Likert scale. The questionnaires were completed by final-year medical students, trainees of foundation year 1 (FY1) and 2 (FY2), and their supervisors.
  
  
  RESULTS
  For all activities listed: (1) the trainees' presumed competence increased over time and (2) the mean scores given by trainees were significantly higher than the mean scores given by supervisors across all years the questionnaire covered. As estimated by both trainees and supervisors, the impact of a responsibility transition, i.e., from medical school to FY1, is larger than that of a licensure transition, i.e., from FY1 (pre-MD) to FY2 (post-MD).
  
  
  CONCLUSIONS
  The transition to formal responsibility with a license to practice medicine seems to have less impact on confidence of trainees and their supervisors to execute critical activities than the transition to informal but significantly higher responsibility.
authors.affiliation: University Medical Center Utrecht, The Netherlands. m.wijnen-meijer@umcutrecht.nl
authors.forename: Marjo
authors.initials: M
authors.lastname: Wijnen-Meijer
authors.forename: Sue
authors.initials: S
authors.lastname: Kilminster
authors.forename: Marieke
authors.initials: M
authors.lastname: Van Der Schaaf
authors.forename: Olle
authors.initials: O
authors.lastname: Ten Cate
mesh_terms: D002983:Clinical Competence; D004501:Education, Medical / Q000458:organization & administration*; D004521:Educational Measurement; D005180:Faculty, Medical / Q000458:organization & administration*; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D007858:Learning; D013997:Time Factors