Comfortable knowing little about lymphoedema? A qualitative study of medical interns in Australia.

Abstract

Knowledgeable doctors are needed for timely assessment, diagnosis and management of lymphoedema. This qualitative study explored the thoughts and feelings of Australian interns (medical graduates in their first postgraduate year) towards (i) their understanding of the lymphatic system and lymphoedema, (ii) curricula pertaining to lymphoedema within their Australian medical degree and (iii) how they perceive that their understanding and medical training in lymphoedema influence their clinical practice. Qualitative semistructured interviews were conducted with interns employed within their first postgraduate year in Australia. Interviews were conducted via Microsoft Teams or telephone, video-recorded, transcribed verbatim and analysed using thematic analysis. Inductive (data-driven) codes identified in the data were organised into themes. The overarching theme was one of ambivalence. Participants noted that they had knowledge gaps related to lymphoedema (theme 1), but were not concerned by them, as they did not consider lymphoedema a condition they were expected to know about at medical school or in clinical practice (theme 2). Furthermore, they questioned the relevance of lymphoedema to their role (theme 3) and they considered lymphoedema care to be the responsibility of others (theme 4). These findings suggest a discord between what interns in this study recall being taught about lymphoedema and what current literature suggests newly graduated doctors should know. Future research is needed to explore the extent to which these findings extend to the perceptions of more senior doctors and how these findings impact the unmet needs of people with lymphoedema in Australia.