New graduates learning to make intervention decisions in acute paediatric hospital settings: Support and influences

Introduction New graduate occupational therapists' experiences of learning to make paediatric intervention decisions within hospital settings are unexplored. New graduates commonly find clinical decision-making challenging. Previous research has predominantly evaluated support programs designed to assist their transition to practice. Exploring new graduates' experiences working in hospital settings is important because they are common employers of new graduates and typically provide substantial support. Method A case study approach enabled exploration of the experiences of four new graduate and perspectives of four experienced occupational therapists working in an Australian paediatric hospital. Data were collected through semi-structured interviews, informal discussions, observations and review of documents. Inductive analysis was used to identify codes and themes within the data. Findings New graduates reported substantial access to workplace supports and resources to inform their intervention decisions. However, the immediacy with which occupational therapists needed to respond to referrals impacted new graduates' ability to consistently access available supports. They were acutely aware of needing to manage clinical risk and actively sought informal support for making intervention decisions. Conclusion Providing opportunities to seek informal support on an 'as-needs' basis was most important for assisting new graduates to obtain reassurance that they were making safe, high-quality intervention decisions.