Beyond the struggles: Using social-developmental lenses on the transition to clinical training

This dissertation aimed to enhance the understanding of how students navigate the transition from classroom-based training to learning from patients in the clinical setting. We used concepts from multiple theories that relate to how social contexts influence learning in some way. We conducted four empirical studies, all involving undergraduate medical students, using scoping review methodology and qualitative and mixed-methods designs. We offer the medical education community insights into the transition period from pre-clinical to clinical training. We first found that most authors in medical education research use negative discourse when describing the transition to clinical training. Additionally, researchers primarily approach this transition as a problem to be solved cognitively, with knowledge and skills sessions to prepare students for their new roles. We found researchers were less likely to consider the social and developmental aspects inherent in students’ navigation of the change to learning and working with patients. We then found evidence that the transition to clinical training is an emotional period, with negative and positive emotions that contribute to students’ identity formation, proactivity regarding their learning and development, and the creation of the students’ social support networks. The transition to clinical training was both a threat and an opportunity for the learning and development of undergraduate medical students, and the social context significantly contributes to whether threat or opportunity is more prominent.