Community-Based Clinical Traineeships: Exploring Physicians’ Perceptions on the Transferability of Learning to Practice

Literature identifies several ways in which a traineeship into a non-traditional community-based clinical setting might positively impacts medical trainees. However, little is known about physicians’ ability to transfer the learning gained from such experience into other clinical contexts. This qualitative study explores, from physicians' perspectives, the application of learning gained from a traineeship within La Maison Bleue, a community-based primary care organization in Montreal, Quebec, Canada, designed for women and families experiencing social vulnerability. The study is based on 12 semi-structured interviews with primary care physicians (n=10) and residents (n=2) who completed a medical traineeship into this setting. NVivo software was used to support thematic analysis. Results show that most participants aimed to apply the learnings gained from their experience, despite organizational and structural barriers often impeding their efforts. It is thus primarily the learnings relating to the relational and patient-centered approach, which the doctor can control on a personal or an interpersonal level, that are effectively actualized in practice. Facilitating factors were perceived more on the human level, but ultimately had only a marginal effect on physicians' actual ability to apply learning. The study provides decision-makers with concrete avenues for action to better support physicians in their willingness to practice medicine differently. By highlighting these findings, the study underscores the ethical and political responsibility of healthcare decision-makers in realizing the transformational potential of medical education.