Manuscripts suggesting preparedness versus unpreparedness of medical graduates from 2009 to 2014 mapped against the outcomes for graduates
| Specific outcome | Prepared: number and reference(s) | Unprepared: number and reference(s) | ||
|---|---|---|---|---|
| Doctor as scientist and scholar (8–12) | ||||
| Knowledge of anatomy (TD09 8*) | 0 | 1 | Dickson et al73 | |
| Understanding disease processes (TD09 8e*) | 2 | Matheson and Matheson42 Watmough et al38† | 1 | Watmough et al37† |
| Apply scientific principles, method and knowledge to medical practice and research (TD09 9*) | 1 | Tallentire et al39 | 0 | |
| Knowledge of clinical, behavioural and social sciences for medicine (TD09 9* and 10*) | 2 | Matheson and Matheson42 Tallentire et al39 | 0 | |
| Basic nutritional care/knowledge (TD09 11h) | 2 | Bleakley and Brennan35† Matheson and Matheson42 | 0 | |
| Total number of different studies | 4 | 2 | ||
| Doctor as practitioner (13–19) | ||||
| Taking a history (TD09 13a) | 8 | Bleakley and Brennan35† Brown et al42 Estcourt et al43 Illing et al28 Matheson and Matheson42 Morrow et al40 Tallentire et al39 Watmough et al37 | 0 | |
| Communicate sensitively, clearly and effectively with patients and relatives (TD09 13b*) | 2 | Bleakley and Brennan35† Matheson and Matheson42 | 0 | |
| Performing a full physical examination (TD09 13c) | 5 | Bleakley and Brennan35† Matheson and Matheson42 Morrow et al40 Tallentire et al39 Watmough et al37 | 0 | |
| Perform a mental-state examination (TD09 13d) | 2 | Matheson and Matheson42 Watmough et al37 | 1 | Gordon56 |
| Hold conversation with patient and family to explain a mistake (TD09 13g*) | 1 | Wijnen-Meijer et al52‡ | 1 | Wijnen-Meijer et al52‡ |
| Using evidence and guidelines for patient care (including developing critical thinking) (TD09 14a*) | 1 | Watmough et al37† | 4 | Bleakley and Brennan35† Matheson and Matheson42 Tallentire et al39 Watmough et al37† |
| Recognising the social and emotional factors in illness and treatment (TD09 14a*) | 3 | Bleakley and Brennan35† Matheson and Matheson42 Watmough et al37† | 1 | Watmough et al37† |
| Clinical reasoning and making a diagnosis (TD09 14b,f*) | 3 | Bleakley and Brennan35† Laws et al76 Watmough et al37 | 8 | Atrey et al40 Brown et al42 Davis and MacLullich54 Estcourt et al43 George et al55 Matheson and Matheson42 Morrow et al40 Tallentire et al39 |
| To draw up an examination plan for a new patient at the outpatient department (TD09 14c*) | 1 | Wijnen-Meijer et al52‡ | 1 | Wijnen-Meijer et al52‡ |
| Selecting appropriate investigations and interpreting the results (TD09 14d*) | 2 | Bleakley and Brennan35† Watmough et al37 | 1 | Matheson and Matheson42 |
| Protecting patients' rights (TD09 14g*) | 1 | Matheson and Matheson42 | 0 | |
| Planning discharge for patients (TD09 14g*) | 1 | Bleakley and Brennan35† | 0 | |
| Identifying signs of abuse (TD09 14i) | 0 | 1 | Estcourt et al43 | |
| End of life care (TD09 14j) | 0 | 2 | Gibbins et al75 Linklater62 Bowden et al74 | |
| Writing out part A of a cremation form (TD09 14j*) | 0 | 1 | Morrow et al40 | |
| Communicate effectively in multidisciplinary/interdisciplinary team (TD09 15*) | 2 | Matheson and Matheson42 Wijnen-Meijer et al52‡ | 3 | Lewis and Tully61 McGettigan et al60 Wijnen-Meijer et al52‡ |
| Communicate effectively in a medical context (TD09 15*) | 1 | Tallentire et al39 | 0 | |
| Communicating effectively with colleagues (TD09 15a*) | 4 | Bleakley and Brennan35† Illing et al28 Matheson and Matheson42 Wijnen-Meijer et al52 | 1 | Watmough et al37 |
| Breaking bad news to patients and relatives (TD09 15d) | 3 | Bleakley and Brennan35† Matheson and Matheson42 Wijnen-Meijer et al52‡ | 4 | Linklater et al62 Illing et al28 Wijnen-Meijer et al52‡ Bowden et al74 |
| Dealing with difficult or violent patients (TD09 15e) | 0 | 2 | Matheson and Matheson42 Morrow et al40 | |
| Treating acutely ill patients (TD09 item 16) | 3 | Carling et al26 Burns65 Tallentire et al77 | 2 | Illing et al28 Watmough et al37 |
| Diagnose and manage acute medical emergencies (TD09 16b) | 3 | Carling et al26 Hobson28† Tallentire et al39†‡ | 9 | Bleakley and Brennan35† Gordon56 Hobson28 † Illing et al28 Kavanagh et al47 Mastoridis et al57 Morrow et al40 Tallentire et al39 51 77†‡ Wijnen-Meijer et al52 |
| Explain drug prescription choice to a pharmacist (TD09 17b) | 1 | Wijnen-Meijer et al52‡ | 1 | Wijnen-Meijer et al52‡ |
| Prescribing safely (TD09 17c) | 5 | Dornan et al10§ Matheson and Matheson42 Morrow et al40 Tallentire et al39‡ Watmough et al37† | 23 | Ahmed et al52 Brown et al42 Bertels et al9 Bleakley and Brennan35† Brennan et al44 Dornan et al10§ Franklin et al46 Goldacre et al35 Harding et al11 Illing et al27 Kavanagh et al47 Kilminster et al48 Lewis and Tully61 Mattick et al13 Morrow et al40 Ross et al78 Ross et al49 Rothwell et al14 Ryan et al50 Seden et al54 Tallentire et al51 Watmough et al37† Wijnen-Meijer et al52 |
| Calculate drug dosage and record outcome (TD09 17d) | 0 | 5 | Bleakley and Brennan35† Dornan et al10 Matheson and Matheson42 Mattick et al13 Morrow et al40 | |
| Apply knowledge of alternative and complementary therapies and how these may affect other treatments (TD09 17h) | 0 | 1 | Morrow et al40 | |
| Keeping an accurate and relevant medical record (TD09 19a) | 2 | Brown et al42 Matheson and Matheson42 | 1 | Bleakley and Brennan35† |
| Maintaining confidentiality (TD2009 19c*) | 1 | Matheson and Matheson42 | 0 | |
| Using informatics as a tool in medical practice (TD09 19e) | 2 | Bleakley and Brennan35† Watmough et al37† | 2 | Bleakley and Brennan35† Watmough et al37† |
| Total number of different studies | 15 | 37 | ||
| Doctor as professional (20–23) | ||||
| Overall patient-centred practice and humane care/recognises all aspects of care (TD09 20b*) | 1 | Bleakley and Brennan35† | 1 | McGettigan et al60 |
| Acting in a professional manner (with honesty and probity) (TD09 20c*) | 2 | Bleakley and Brennan35† Matheson and Matheson42 | 0 | |
| Providing appropriate care for people of different cultures (TD09 20d*) | 2 | Bleakley and Brennan35† Matheson and Matheson42 | 1 | Bleakley and Brennan35† |
| Knowledge of key mental health legislation (TD09 20f*) | 1 | Wadoo et al69 | 0 | |
| Understanding ethical and legal issues (such as confidentiality and consent) (TD09 20f*) | 6 | Bleakley and Brennan35† Brown et al42 Matheson and Matheson42 Preston-Shoot and McKimm78 Tallentire et al39 Watmough et al37† | 4 | Linklater et al61 Morrow et al40 Wadoo et al68 Watmough et al37† |
| Sickness certification (TD09 20g*) | 0 | 1 | Walters et al79 | |
| Identifying and organising own learning needs, reflective practice (TD09 21b*) | 3 | Brown et al42 Matheson and Matheson42 Watmough et al37† | 3 | Bleakley and Brennan35† Tallentire et al39 Watmough et al37† |
| Time management (TD09 21d*) | 1 | Bleakley and Brennan35† | 4 | Bleakley and Brennan35† Illing et al28 McGettigan et al60 Watmough et al37 |
| Asking for help (TD09 21e*) | 2 | Brown et al42 Matheson and Matheson42 | 0 | |
| Being aware of their limitations (TD09 21e*) | 4 | Bleakley and Brennan35† Brown et al42 Matheson and Matheson42 Watmough et al37 | 1 | †Watmough et al37 |
| Undertaking a teaching role (TD09 21f*) | 2 | Bleakley and Brennan35† Wijnen-Meijer et al52‡ | 2 | Bleakley and Brennan35† Wijnen-Meijer et al52‡ |
| Working effectively in a team (TD09 22*) | 6 | Bleakley and Brennan35† Brown et al42 Illing et al28 Matheson and Matheson42 Morrow et al40 Watmough et al37† | 1 | Watmough et al37† |
| Understanding roles of other healthcare professionals (TD09 22a*) | 1 | Watmough et al37† | 1 | Watmough et al37† |
| Ensuring and promoting patient safety (TD09 23a*, d*) | 1 | Bleakley and Brennan35† | 1 | McGettigan et al60 |
| Coping with uncertainty (TD09 23b) | 0 | 2 | Bleakley and Brennan35† Watmough et al37 | |
| Using knowledge of the structures and functions of the NHS in practice (TD09 23c*) | 0 | 1 | Morrow et al40 | |
| Reporting and dealing with error and safety incidents (TD09 23d*) | 0 | 3 | Ahmed et al53 Bleakley and Brennan35† Cresswell et al67 | |
| Clinical governance (TD09 23d*) | 1 | Bleakley and Brennan35† | 1 | Bleakley and Brennan35† |
| Knowledge/using audit to improve patient care (TD09 23e*) | 3 | Bleakley and Brennan35† Brown et al42‡ Watmough et al37† | 3 | Bleakley and Brennan35† Brown et al42 ‡ Watmough et al37† |
| Dealing appropriately, effectively, and in patients' interests with problems in the performance, conduct or health of colleagues (TD09 23d*, i*) | 0 | 1 | Matheson and Matheson42 | |
| Reducing the risk of cross-infection (TD09 23h) | 1 | Bleakley and Brennan35† | 0 | |
| Managing their health, including stress (TD09 23i*) | 0 | 1 | Bleakley and Brennan35† | |
| Total number of different studies | 10 | 14 | ||
| Items not directly mapped to outcomes for graduates | ||||
| To give a presentation at the clinical team meeting after a night shift | 1 | Wijnen-Meijer et al52 | ||
| Write letter of referral to colleague | 1 | Wijnen-Meijer et al52‡ | 1 | Wijnen-Meijer et al52‡ |
| Able to participate in effective handover | 0 | 3 | Burns65 Cleland et al63 Raduma-Tomàs et al66 | |
| Understanding how the clinical environment works (not an outcome for graduates but appears in TD09 106, p. 54) | 1 | Matheson and Matheson42 | 5 | Illing et al28 Kilminster et al48 Mattick et al13 Tallentire et al39 Van Hamel and Jenner67 |
| Understanding the relationship between primary/social care and hospital care | 0 | 2 | Bleakley and Brennan35† Watmough et al37 | |
| Knowledge and understanding of rehabilitation and care within institutions and the community | 1 | Matheson and Matheson42‡ | 1 | Matheson and Matheson42‡ |
| Understanding the purpose and practice of appraisal | 0 | 1 | Bleakley and Brennan35† | |
| Use information and technology effectively in medical context | 1 | Tallentire et al39 | ||
| Organisational decision-making | 0 | 1 | Bleakley and Brennan35† | |
| Applying clinical pharmacology and therapeutics to prescribing | 0 | 2 | Harding et al11 Mattick et al13 | |
| To ask a representative critical questions about the pharmaceutical product | 0 | 1 | Wijnen-Meijer et al52 | |
| Preoperative assessment of patients | 0 | 1 | Morrow et al40 | |
| Taking part in advanced life support | 1 | Bleakley and Brennan35† | 1 | Bleakley and Brennan35† |
| Functioning safely in an acute ‘take’ team | 0 | 1 | Bleakley and Brennan35† | |
| Educating patients (health and public health) promotion | 1 | Bleakley and Brennan35† | 0 | |
| Maintaining good quality care | 1 | Bleakley and Brennan35† | 0 | |
| Carrying out a literature search | 1 | Watmough et al37† | 1 | Watmough et al37† |
| Skills of close observation | 0 | 1 | Bleakley and Brennan35† | |
| Total number of different studies | 5 | 14 | ||
*Partially relevant to the specified outcome.
†Different cohorts, newer evidencing greater preparedness.
‡Trainees suggest preparedness where supervisors do not.
§Self-reports suggest prepared and observational data suggest unprepared.
Blue text, self-report only; Red text, mixed participants/methods; Black text, trainer report only.