Extracción de los alginatos

In qualitative studies, the literature review is an evolutionary process, and usually requires going back to the literature to explore themes as the data collection and analysis progresses (Creswell 2003; Denzin and Lincoln 2003). Whilst looking at the decision factors that influence choice of specialty for medical students, junior doctors, GP registrars and practising GPs, it became apparent that it was necessary to first look at some of the key aspects of the decision-making and career-choice process itself.

The literature review for this process was broken up into several main aspects. The first step involved understanding the nature and background of the decision process itself. To afford a better understanding of the decision process within the context of the current research, a careful review of decision theory and an understanding of how people make decisions in general were required. The literature review was

20 conducted via reviewing some key books (Dewey [1910] 1978; Manktelow 2012; Wason and Johnson-Laird 1972; Tennyson et al. 1997) and referring to online databases (ProQuest, PsycINFO). The online search included search terms such as “decision theory”, “decision factors” and “decision choices”. While a multitude of literature was found on these topics, focus was placed on seminal pieces of work (Condorcet 1793; Homans 1958; Whale and Boyle 1966; Wason and Johnson-Laird 1972), key theoretical concepts (Mintzberg, Raisinghani, and Théorêt 1976; Scott 2000) and the decision-making process (Keller 1989) within the context of the study.

The next step of the literature review required a better understanding of career theory and an understanding of the models used by individuals in relation to career choices. Within the context of the current research, the individuals had already made a broad career choice in the field of medicine; however, there are great complexities in translating that broader choice into an actual specialty, and, in fact, the various specialties can offer differing career pathways (General Practice

Education & Training 2007). Some key books (Schein 1993; Parsons 1909; Ginzberg et al. 1951; Jung et al. 1971) were reviewed and online searches across databases (ProQuest, PsycINFO) were conducted. The search terms included “career theory” and “career choices”. There was a myriad of literature available, but focus was placed on understanding the key concepts and summarising the key theories (refer table 2.1).

As this study has sought to understand the generational differences of the

participants, who were in notably different stages of their career and personal life, literature related to generational attitudes towards career development (Lankard 1995; Filipczak 1994), job satisfaction (Thomas 2002; Kunreuther 2003), leadership (Yu and Miller 2005; Harris 2007) and remuneration (Turetsky 2006; Shaul 2007) were also considered. Some key books were reviewed (Zemke, Raines, and Filipczak 2000; Lancaster and Stillman 2002), and a broad electronic search was conducted using terms such as “generation x, y, z” combined with “remuneration”, “job satisfaction”, “motivation”. As gender had also been tabled as a potential decision-

21 influencing factor during the familiarisation study, a brief overview of the literature related to gender differences in career choices was also explored (Flabbi 2011; Heiligers 2012). The search term “career choice and gender” was used for this particular review. Again, the focus was primarily to understand and explain the key issues in these areas to aid the study.

The researcher also considered game theory (Morgenstern 1944) but this is mainly used in the study of mathematical models (Myerson 1991) and the field of

economics and political science (Rasmusen 2006) and not career decision making. It was noted that decision theory and career theory were more commonly used in literature in relation to career choices and choice of medical specialty. Similarly, constructivism was also considered but the researcher noted that this is widely acknowledged as a learning theory (Fosnot 2005) and has been more widely used in the context of learning theories and teaching methods in education rather than career decision-making. The broader literature review pointed towards career theory and decision theory as being most relevant to this research and hence these were used as the key theories related to this research and are discussed in detail.

The final step of the literature review involved an exhaustive review of other related research within Australian and international contexts that had looked at career choices and decision-making within the broad context of general practice. An exhaustive review of over 5000 articles was carried out with the help of a research assistant. The research was conducted entirely online, and used key industry

databases (MEDLINE, PubMed) as well as specific medical journals in the UK (British

Medical Journal) and Australia (Medical Journal of Australia). The search terms

included variations and combinations of the following terms: “General Practice”, “Family Medicine”, and “Career Choice”. Country-specific searches using the above variables were also included for Australia, UK, New Zealand, Canada and the USA.

The articles collected were reviewed and entered into a table (Appendix 1). These were further were broken into specific areas for discussion in relation to prestige

22 (Petchey, Williams, and Baker 1997; Creed, Searle, and Rogers 2010), remuneration (Grayson, Newton, and Thompson 2013), gender (Buddeberg-Fischer et al. 2006; Diderichsen et al. 2013), work-life balance (Larkins et al. 2004; Newton, Grayson, and Thompson 2005), role models (Kamien 2004), clinical rotations (Tolhurst and Stewart 2005) and other clinical (Senf, Campos-Outcalt, and Kutob 2005; Gaspar, Jesus, and Cruz 2011) factors that impact choice of specialty.

Given the context of this research, the steps outlined above were not part of a linear process, but rather were a part of an iterative exercise that involved going back and forth multiple times to associate relevant literature within the context of the current study. Often, new readings in one area triggered additional readings in another area, and it should be noted that what is presented below is the culmination of the entire process. So whilst the following topics are represented in a linear fashion, this is purely to aid synthesis by the reader, and it encapsulates the richness of a true qualitative study where every step of the methodology has a constructivist foundation as defined by key thought leaders in the field of qualitative research (Denzin and Lincoln 2003; Janesick 2000; Strauss and Corbin 1990; Creswell 1998, 2003).