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A Realist Evaluation of Theory about Triggers for Doctors Choosing a Generalist or Specialist Medical Career
There is a lack of theory about what drives choice to be a generalist or specialist doctor, an important issue in many countries for increasing primary/preventative care. We did a realist evaluation to develop a theory to inform what works for whom, when and in what contexts, to yield doctors’ choic...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7699208/ https://www.ncbi.nlm.nih.gov/pubmed/33218189 http://dx.doi.org/10.3390/ijerph17228566 |
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author | O’Sullivan, Belinda McGrail, Matthew Gurney, Tiana Martin, Priya |
author_facet | O’Sullivan, Belinda McGrail, Matthew Gurney, Tiana Martin, Priya |
author_sort | O’Sullivan, Belinda |
collection | PubMed |
description | There is a lack of theory about what drives choice to be a generalist or specialist doctor, an important issue in many countries for increasing primary/preventative care. We did a realist evaluation to develop a theory to inform what works for whom, when and in what contexts, to yield doctors’ choice to be a generalist or specialist. We interviewed 32 Australian doctors (graduates of a large university medical school) who had decided on a generalist (GP/public health) or specialist (all other specialties) career. They reflected on their personal responses to experiences at different times to stimulate their choice. Theory was refined and confirmed by testing it with 17 additional doctors of various specialties/career stages and by referring to wider literature. Our final theory showed the decision involved multi-level contextual factors intersecting with eight triggers to produce either a specialist or generalist choice. Both clinical and place-based exposures, as well as attributes, skills, norms and status of different fields affected choice. This occurred relative to the interests and expectations of different doctors, including their values for professional, socio-economic and lifestyle rewards, often intersecting with issues like gender and life stage. Applying this theory, it is possible to tailor selection and ongoing exposures to yield more generalists. |
format | Online Article Text |
id | pubmed-7699208 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-76992082020-11-29 A Realist Evaluation of Theory about Triggers for Doctors Choosing a Generalist or Specialist Medical Career O’Sullivan, Belinda McGrail, Matthew Gurney, Tiana Martin, Priya Int J Environ Res Public Health Article There is a lack of theory about what drives choice to be a generalist or specialist doctor, an important issue in many countries for increasing primary/preventative care. We did a realist evaluation to develop a theory to inform what works for whom, when and in what contexts, to yield doctors’ choice to be a generalist or specialist. We interviewed 32 Australian doctors (graduates of a large university medical school) who had decided on a generalist (GP/public health) or specialist (all other specialties) career. They reflected on their personal responses to experiences at different times to stimulate their choice. Theory was refined and confirmed by testing it with 17 additional doctors of various specialties/career stages and by referring to wider literature. Our final theory showed the decision involved multi-level contextual factors intersecting with eight triggers to produce either a specialist or generalist choice. Both clinical and place-based exposures, as well as attributes, skills, norms and status of different fields affected choice. This occurred relative to the interests and expectations of different doctors, including their values for professional, socio-economic and lifestyle rewards, often intersecting with issues like gender and life stage. Applying this theory, it is possible to tailor selection and ongoing exposures to yield more generalists. MDPI 2020-11-18 2020-11 /pmc/articles/PMC7699208/ /pubmed/33218189 http://dx.doi.org/10.3390/ijerph17228566 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article O’Sullivan, Belinda McGrail, Matthew Gurney, Tiana Martin, Priya A Realist Evaluation of Theory about Triggers for Doctors Choosing a Generalist or Specialist Medical Career |
title | A Realist Evaluation of Theory about Triggers for Doctors Choosing a Generalist or Specialist Medical Career |
title_full | A Realist Evaluation of Theory about Triggers for Doctors Choosing a Generalist or Specialist Medical Career |
title_fullStr | A Realist Evaluation of Theory about Triggers for Doctors Choosing a Generalist or Specialist Medical Career |
title_full_unstemmed | A Realist Evaluation of Theory about Triggers for Doctors Choosing a Generalist or Specialist Medical Career |
title_short | A Realist Evaluation of Theory about Triggers for Doctors Choosing a Generalist or Specialist Medical Career |
title_sort | realist evaluation of theory about triggers for doctors choosing a generalist or specialist medical career |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7699208/ https://www.ncbi.nlm.nih.gov/pubmed/33218189 http://dx.doi.org/10.3390/ijerph17228566 |
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