Table 4.

Experienced difficulties with own (setting-specific) competencies

Insufficient language competencies	Knowledge of everyday language
	Knowledge of medical jargon and nomenclature
	Knowledge of colloquial terms for medical issues
	Written expression and use of grammar
	Understanding dialects
Insufficient knowledge of the German healthcare system	The scope of own and co-worker’s responsibilities
	Organization of healthcare outside of hospital setting
	Legal requirements regarding treatment of patients and patient data
	Care processes and technical equipment used within hospital
Insufficient clinical competencies	Clinical knowledge exceeding own specialist field
	Experience with certain diagnostic/therapeutic techniques
	Experience with treating certain medical conditions
	Further necessary practical skills like taking blood
Insufficient cultural knowledge	Cultural and historical context as basis for psychotherapy
	Cultural (implicit) rules of conduct like how to show emotions
Further competencies lacking	Knowledge of machines causing accidents as basis for surgical interventions
	Handling own deficiencies/insecurities well
	Adjusting to and accepting the new environment