Qualitative study of new doctor induction and socialisation.

Aim: Junior doctors joining EDs are required to rapidly acquire new knowledge and skills, but there is little research describing how this process can be facilitated. We aimed to understand what would make ED formal induction and early socialisation more effective.

Methods: Qualitative study; informal interviews of junior doctors, consultants and nursing staff and direct observation of clinical interactions, induction and training in a single ED in an English Emergency Department between August and October 2019. We used constant comparison to identify and develop themes.

Findings: New junior doctors identified that early socialisation should facilitate patient safety and a safe learning space, with much of this process dependent on consultant interactions rather than formal induction. Clear themes around helpful and unhelpful consultant support and supervision were identified. Consultants who acknowledged their own fallibility and maintained approachability produced a safe learning environment, while consultants who lacked interest in their juniors, publicly humiliated them or disregarded the junior doctors' suggestions were seen as unhelpful and unconstructive.

Conclusion: Effective socialisation, consistent with previous literature, was identified as critical. Junior doctors see consultant behaviours and interactions as key to creating a safe learning space.