Exploring healthcare graduates' conceptualisations of preparedness for practice: a longitudinal qualitative research study.

Ottrey, Ella; Rees, Charlotte E; Kemp, Caitlin; Brock, Tina P; Leech, Michelle; Lyons, Kayley; Monrouxe, Lynn V; Morphet, Julia; Palermo, Claire

INTRODUCTION While preparedness for practice (P4P) has been variously described, little shared understanding exists about what P4P is across the health professions. How P4P is conceptualised matters, because this shapes how stakeholders think, talk about, and act towards it. Further, multiple understandings can result in diverse expectations for graduate performance. This study therefore explores healthcare learners' solicited and unsolicited conceptualisations of P4P over their early graduate transition. METHODS We conducted longitudinal qualitative research including individual and group entrance interviews (phase 1: n=35), longitudinal audio-diaries (phase 2: n=30), and individual and group exit interviews (phase 3: n=22) with learners from four disciplines (dietetics, medicine, nursing and pharmacy). We employed framework analysis to interrogate data cross-sectionally and longitudinally. RESULTS We found 13 conceptualisations of P4P (e.g. knowledge, confidence), broadly similar across the disciplines. We found some conceptualisations dominant in both solicited and unsolicited talk (e.g. skills), some dominant only in solicited talk (e.g. competence), and others dominant only in unsolicited talk (e.g. experience). While most conceptualisations appeared relatively stable across time, some appeared to dominate at certain time points only (e.g. employability and skills in phases 1 and 2, and competence in phase 3). DISCUSSION This novel study extends previous uniprofessional work by illustrating a broader array of conceptualisations, differences between professions, solicited versus unsolicited talk, and longitudinal cohort patterns. We encourage healthcare educators to discuss these different P4P understandings in graduate transition interventions. Further research is needed to explore other stakeholders' conceptualisations, and over a duration beyond the early graduate transition.