Assessment of the cognitive representations of Family Medicine residents on "being the ideal Family Physician"

Introduction and Aim: General practice / family medicine is an academic and scientific discipline, with its own educational content, research, evidence-base and clinical activity, and a clinical specialty orientated to primary care. Cognitive representation refers to how an individual makes sense of an event, situation, object or person in her/his mind. In this study, we aimed to reveal the cognitive representations of family medicine residents on ideal and non-ideal family physician characteristics. Material and Method: Our study incleded 40 family medicine residents of Cukurova University Department of Family Medicine, between 22 February, 2019 and 31 July, 2019. A questionnaire was created using the repertoire grid technique and were self-completed by the residents. Data was installed and analyzed using statistical pocket program. Results: The mean age of residents was 28.03 ± 2.56 years, 28 (70%) were female and 12 (30%) were male. The year of graduation from medical school varied between 2008 and 2018. The mean duration of working as a resident was 16.75 ± 11.54 months, 21 (52.5%) were first year, nine (22.5%) were second year and ten (25%) were third year residents. Of participants 35 (87.5%) stated that they had chosen their profession voluntarily, 24 of the participants (60%) answered "yes" to the question "Would you choose the same profession again?". It was found that the residents self-values related to the profession were moderate (d = 0.88). The current self-element was positioned closely to the element "I as a family physician from the eyes of other specialties (d = 0.18). The element "What kind of family physician I want to be" is clearly positioned close to the elements of "A good family physician I know" (d = 0.25) and "An ideal family physician for me" (d = 0.06). In the self-identity graphic; the normative self-element is located in the ambivalent area, the "Bad family physician I know" element in the conflict area, and the other elements in the acceptance area. The current self-element of the participants was negatively associated with all characteristics in terms of personal structures in the repertoire grid. Family medicine residents saw themselves as insufficient especially in terms of "care provider" (r = -0.50), "decision maker" (r = -0.49), "manager" (r = -0.46) personal structures. Family medicine residents also strongly negatively associated the element "I as a family physician from the eyes of other specialties with the features in the repertoire grid form. In the essential components analysis graphic, it was seen that the personal characteristics that family medicine residents apply to the ideal family physician and the family physician they want to be are being a decision maker, having emotional stability, being a care provider, manager and community leader. There was no significant difference between the group answering the question "Would you choose the same profession again?" "Yes" or "No". Both groups had moderate self-esteem; self-esteem of those who said "No" (d = 0.83) was found to be higher than those who said "Yes" (d = 0.90). The current self-element of both groups was negatively associated with all personal characteristics. They perceived themselves positively from the eyes of the patients and other family physicians, and negatively from the eyes of other specialties. It was found that both those who answered "No" and those who answered "Yes" had cognitive simplicity and had one-dimensional perception. Of adjectives in the repertoire network form 96% explained the family physician in minds of the ones who said "Yes" and 94% of those who said "No". Conclusion: Family medicine residents should be experts, equipped with the competencies defined. The residency training program should be planned in such a way that the physician will improve knowledge, skills and attitudes. Adapting the current specialty training curriculum, according to the personal characteristics and cognitive representations created for family medicine residents to have adequate knowledge and skills, will contribute to the residents to fulfill their tasks in primary care in an ideal way. Key-words: Family Medicine, Resident, Cognitive Representation, Ideal Family Physician, Specialty Training