Electronic Thesis and Dissertation Repository

Thesis Format

Monograph

Degree

Master of Clinical Science

Program

Family Medicine

Supervisor

Brown, Judith Belle

2nd Supervisor

Watling, Chris

Joint Supervisor

Abstract

Aim: To gain an understanding of the experience of medical training for nurses who retrain as doctors.

Methods: Using a Constructivist Grounded Theory design, semi-structured interviews were conducted with thirteen medical students and residents who had completed nursing training prior to entering medical school. Interviews were audiotaped and professionally transcribed. Transcripts were coded and analysis in an inductive manner to construct central themes.

Findings: Many left nursing due to negative effects of a hierarchal system. As preclinical medical students they felt both advantaged and burdened by their advanced clinical knowledge. During clinical placements, they experienced social distress and role confusion whilst working in familiar environments and alongside former nursing colleagues. Nursing identity diminishes but is never lost.

Conclusions: The participants experienced complex social stressors as they moved from an oppressed group to a dominant group within a hierarchal system. These stressors are not likely experienced by other medical trainees.

Summary for Lay Audience

Based on observations from a medical educator (AR), it was suspected that nurses who retrain as doctors have a different experience of medical training than their non-nursing peers. There were very few academic studies that examined nurses as medical trainees, although there were many online forums and published anecdotes about nurses who become doctors. This study was undertaken to explore the experiences of nurses during medical training.

Thirteen medical students and residents from one medical school in Ontario, who had completed nurses training prior to starting medical school, were interviewed. The transcripts from these interviews were reviewed by the researchers (AR, JB, and CW) to construct key themes.

Although some of the participants used nursing as a gateway to medicine, most left nursing due to untenable work environments, a lack of clinical autonomy, and a desire for more knowledge. During the early years of medical school, before their clinical placements, the participants felt both advantaged and burdened by their advanced clinical knowledge. When they were on clinical placements, they felt at home in the clinical settings but struggled with role confusion. This was especially true for those individuals who continued to work as nurses during medical school. Furthermore, working alongside former nursing colleagues sometimes lead to awkward moments.

Their professional identity did not simply transition from ‘nurse’ to ‘doctor’. Instead, they developed a hybrid identity in which their identity as a nurse persisted and was blended with their new identity as medical student or doctor. Moving from being a nurse to being a doctor was social complicated as it involved moving from an oppressed group within the medical hierarchy to the dominant group. Ultimately, the influence of this hierarchy was perceived at all stages of their transition and creates stressors that are likely unique to this population, even in comparison to other health professionals who retrain as doctors.

As doctors, these former nurses hope to change the culture of medicine for the better.

Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 License.

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