Multiple and multidimensional transitions during COVID-19 (and beyond): a qualitative longitudinal study of Scottish doctors

Abstract

Background:
Doctors experience multiple, interacting transitions throughout their careers which can challenge wellbeing in multiple domains. The wellbeing of doctors’ is a priority issue and COVID-19 has magnified existing challenges. Whilst anecdotal reports are common in the media, there is limited empirical study of doctor’s experiences particularly how wellbeing is impacted beyond the physical and psychological and into the social and cultural domains. To address this gap, we explored the transitions experiences of doctors during (and BEYOND) the COVID-19 pandemic and how this affected their wellbeing in multiple domains.
Summary of work:
Doctors working across the career continuum in primary and secondary care (n=100) were recruited to a four-month longitudinal audio-dairy (LAD) study. One hundred doctors from all 14 NHS territorial boards in Scotland undertook an initial interview. Of these, 67 doctors shared diaries for between 2-4 months and 83 completed second interviews after 2-4 months, a further set of interviews are planned in March 2021 with this cohort. Data were thematically analysed using an abductive approach informed by Multiple Multi-Dimensional Transitions (MMT) theory and the Trainee-trained transitions (T3D) model.
Summary of results:
Doctors experienced multiple interacting and impacting transitions in multiple contexts including: their workplace (e.g. redeployment/working from home); individual roles (e.g. patient-doctor relationship); educational context (e.g. increased online flexible learning) and home life (e.g. home schooling/spending more time with family). These transitions impacted their wellbeing (both positively and negatively) in multiple domains including: psychological (e.g. anxiety around contracting the virus); physical (e.g. discomfort with long periods of wearing PPE); social (e.g. new ways of team working with colleagues); and cultural (e.g. prioritisation of rest areas for staff).
Discussion and Conclusion:
Our study shows that core constructs of wellbeing are multi-faceted and interconnect with both MMT theory and the T3D model. Understanding these constructs will allow medical educators and policy makers to plan for and support doctors’ wellbeing during and beyond the current pandemic.
Take Home Messages:
A transitions lens provides a way to explore the complexity of doctors’ experiences during times of uncertainty both during and beyond the COVID-19 pandemic. Furthermore, this approach allows us to better understand all facets of wellbeing, particularly in the cultural and social domains which are currently underdeveloped.

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https://discovery.dundee.ac.uk/en/publications/b4b6d10b-417c-4b50-a37b-32f7174c5df3