Workplace support for first-year early career professionals: a comparative analysis of newly-qualified doctors and secondary school teachers

Abstract

CONTEXT: Both newly qualified doctors and teachers operate within ‘hot action’ environments, responding to constantly changing demands, and balancing routine responses against deliberate reflection. First-year transitions are particularly crucial, as these new professionals face steep learning curves and increased stress levels which can lead to poor mental health, burnout and attrition. This represents a loss of societal investment and negatively impacts upon student and patient outcomes. We know that the workplace is an important site of learning, where informal support from colleagues can aid transitions and professional development. Cross-professional comparisons are an under-used tool, which can shed light on parallels and divergences between different professional contexts, and help identify the features of workplaces which make them more supportive. METHODS: A comparative research design was conducted in three integrated stages, to explore narrative data from early-career professionals in both medicine and education. First, a systematic secondary analysis of interviews and audio diaries, from 52 UK doctor participants in their first year of foundation training (F1s), to explore who provided informal workplace support, the types of support provided and factors influencing this. Secondly, collection and analysis of new narrative interviews with 11 newly qualified teachers (NQTs) working in English secondary schools, also exploring the support they received from others. Lastly, a comparative analysis of these findings to explore similarities and differences in support for these two professions, and identify over-arching factors which influence support seeking and provision for new professionals in ‘hot action’ workplaces. The main theoretical influence underpinning this analysis was that of structure and agency, which shaped the development of models of workplace support for newly qualified professionals so as to include a consideration of how the various features of workplace environments might enable or constrain individual agency. RESULTS: The medical data analysis uncovered many additional support sources for F1s, including nurses, pharmacists, microbiologists, peers and near-peers, and a range of allied healthcare staff. These allowed F1s to draw upon different pools of expertise and experience, given difficulties accessing senior support. NQTs often drew support from allocated mentors and seniors within subject departments, but some also obtained support from allied staff such as TAs, behavioural and learning support staff, or through wider teaching networks including those facilitated by social media. Support from colleagues for F1s and NQTs included: information and advice on practice, orientation to local settings, collaborative development activities, observation and feedback, and socioemotional support. Some common barriers to support were the variability of departmental cultures, limited opportunities for informal contact, and negative inter-group perceptions. However, a number of stories described how novices overcame barriers through agentic action, such as seeking support from alternative sources. A model of workplace support was devised which summarises the features of workplace environments which might influence the seeking and provision workplace support, at the level of the individual, social, organisational and material. This model might be tested within similar ‘hot-action’ workplace environments, used as a tool for future research, or to evaluate the extent to which specific workplace environments facilitate support for new professionals. CONCLUSIONS: In both professional contexts, supportive working relationships could be enhanced through broad strategies which aim to break down barriers, build relationships, create environments of trust and cultivate professional agency. Such measures might include: greater utilisation of existing knowledge sources such as near-peers and allied staff; improved role understanding and better communication with specialised staff; creating opportunities for informal contact via shared social spaces, events and training; and communicating via professional education the successful strategies used by previous early-career professionals to meet their support needs. Future research might further explore the features which underlie positive local cultures of supportivity, as well as developing ecological or whole-systems approaches to understanding workplace support.