title: How prepared are UK medical graduates for practice? A rapid review of the literature 2009-2014.
abstract: To understand how prepared UK medical graduates are for practice and the effectiveness of workplace transition interventions.
  
  
  
  A rapid review of the literature (registration #CRD42013005305).
  
  
  
  Nine major databases (and key websites) were searched in two timeframes (July-September 2013; updated May-June 2014): CINAHL, Embase, Educational Resources Information Centre, Health Management Information Consortium, MEDLINE, MEDLINE in Process, PsycINFO, Scopus and Web of Knowledge.
  
  
  
  Primary research or studies reporting UK medical graduates' preparedness between 2009 and 2014: manuscripts in English; all study types; participants who are final-year medical students, medical graduates, clinical educators, patients or NHS employers and all outcome measures.
  
  
  
  At time 1, three researchers screened manuscripts (for duplicates, exclusion/inclusion criteria and quality). Remaining 81 manuscripts were coded. At time 2, one researcher repeated the process for 2013-2014 (adding six manuscripts). Data were analysed using a narrative synthesis and mapped against Tomorrow's Doctors (2009) graduate outcomes.
  
  
  
  Most studies comprised junior doctors' self-reports (65/87, 75%), few defined preparedness and a programmatic approach was lacking. Six themes were highlighted: individual skills/knowledge, interactional competence, systemic/technological competence, personal preparedness, demographic factors and transitional interventions. Graduates appear prepared for history taking, physical examinations and some clinical skills, but unprepared for other aspects, including prescribing, clinical reasoning/diagnoses, emergency management, multidisciplinary team-working, handover, error/safety incidents, understanding ethical/legal issues and ward environment familiarity. Shadowing and induction smooth transition into practice, but there is a paucity of evidence around assistantship efficacy.
  
  
  
  Educational interventions are needed to address areas of unpreparedness (eg, multidisciplinary team-working, prescribing and clinical reasoning). Future research in areas we are unsure about should adopt a programmatic and rigorous approach, with clear definitions of preparedness, multiple stakeholder perspectives along with multisite and longitudinal research designs to achieve a joined-up, systematic, approach to understanding future educational requirements for junior doctors.
authors.affiliation: Chang Gung Medical Education Research Centre (CG-MERC), Chang Gung Memorial Hospital, Taoyuan City, Taiwan.
authors.forename: Lynn V
authors.identifier: 0000-0002-4895-1812
authors.initials: LV
authors.lastname: Monrouxe
authors.affiliation: Aberdeen Royal Infirmary, Aberdeen, UK.
authors.forename: Lisa
authors.initials: L
authors.lastname: Grundy
authors.affiliation: Cardiff University Library Service, Cardiff, Wales, UK.
authors.forename: Mala
authors.initials: M
authors.lastname: Mann
authors.affiliation: School of Social Sciences, Cardiff University, Cardiff, Wales, UK.
authors.forename: Zoe
authors.initials: Z
authors.lastname: John
authors.affiliation: Cardiff University, Cardiff, Wales, UK.
authors.forename: Eleni
authors.initials: E
authors.lastname: Panagoulas
authors.affiliation: CUREMeDE, Cardiff University School of Social Sciences, Cardiff, Wales, UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Bullock
authors.affiliation: Centre for Research in Professional Learning, Graduate School of Education, University of Exeter, Exeter, UK.
authors.forename: Karen
authors.initials: K
authors.lastname: Mattick
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards*; D003479:Curriculum; D004501:Education, Medical / Q000592:standards*; D004521:Educational Measurement / Q000592:standards; D006801:Humans; D007396:Internship and Residency / Q000592:standards; D036301:Qualitative Research; D057566:Self Report; D011795:Surveys and Questionnaires; D006113:United Kingdom
keywords: BASIC SCIENCES; EDUCATION & TRAINING (see Medical Education & Training); GENERAL MEDICINE (see Internal Medicine); INTENSIVE & CRITICAL CARE