Effect of the Learning Climate of Residency Programs on Faculty’s Teaching Performance as Evaluated by Residents

Lombarts, Kiki M. J. M. H.; Heineman, Maas Jan; Scherpbier, Albert; Arah, Onyebuchi A.

doi:10.1371/journal.pone.0086512

Cited by 51 publications

(52 citation statements)

References 28 publications

(32 reference statements)

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“…This finding would make a case for residents rotating between healthcare organizations that vary in size were it not for the fact that this would interfere with the need highlighted by our participants to establish long-term relationships with patients. A final recommendation arising from this research, which has been reiterated on various occasions elsewhere, [42][43][44] is to create a safe learning environment: To enhance learning, residents must feel free to ask their supervisors critical questions and discuss HV3C-related dilemmas and residents' different beliefs.…”

Section: Discussionmentioning

confidence: 99%

The Struggle Is Real: How Residents Learn to Provide High-Value, Cost-Conscious Care

Stammen

Slootweg

Stalmeijer

et al. 2019

Teaching and Learning in Medicine

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Phenomenon: Rising healthcare expenditures threaten the accessibility and affordability of healthcare systems. Research has demonstrated that teaching (junior) physicians to deliver high-value, cost-conscious care can be effective when learning is situated in a supportive environment. This study aims to offer insight into how residents learn to provide high-value, cost-conscious care in the workplace and how the postgraduate training environment influences this learning. Approach: Six homogeneous focus groups were held between August 2015 and July 2016 with 36 residents from six residency programs (dermatology, n ¼ 5; elderly care, n ¼ 8; family medicine, n ¼ 5; internal medicine, n ¼ 6; orthopedic surgery, n ¼ 6; surgery, n ¼ 6). An iterative grounded theory approach was used to analyze the qualitative data. Findings: Influential factors in learning of high-value, cost-conscious care delivery operated on three levels: individual resident, training program, and the workplace. On the individual level, we discerned three types of beliefs regarding HV3C. At the training program level, perceived determinants of learning included resident-supervisor interactions, involvement in decision-making over time, and exposure to variation in care delivery. At the workplace level, learning depended on the availability of professional healthcare expertise and the presence of institutional policy. Insights: Residents struggle to seize high-value, cost-conscious care learning opportunities in the workplace setting. Both residency training programs and workplaces can contribute to creating these learning opportunities. An important starting point is being aware of the different personal beliefs of residents and the approaches to high-value, cost-conscious care on the level of the training program and workplace.

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Section: Discussionmentioning

confidence: 99%

The Struggle Is Real: How Residents Learn to Provide High-Value, Cost-Conscious Care

Stammen

Slootweg

Stalmeijer

et al. 2019

Teaching and Learning in Medicine

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“…Similarly, international literature stresses that clinical departments' learning climate is crucial to the quality of PGME (Genn 2001a(Genn , 2001bWorld Federation for Medical Education 2003;Weiss et al 2013), using key components of faculties' teaching performance and residents' career satisfaction, learning styles and knowledge (Daugherty et al 1998;Delva et al 2004;Cross et al 2006;Shimizu et al 2013;Lombarts et al 2014) to demonstrate this claim. Research into residents' preparedness for practice and professional development (Cross et al 2006;Brown et al 2007;Dyrbye and Shanafelt 2016) suggests the significance of a supportive learning climate for patient care as provided by residents.…”

Section: Introductionmentioning

confidence: 99%

From good to excellent: Improving clinical departments’ learning climate in residency training

et al. 2017

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Introduction: The improvement of clinical departments' learning climate is central to achieving high-quality residency training and patient care. However, improving the learning climate can be challenging given its complexity as a multi-dimensional construct. Distinct representations of the dimensions might create different learning climate groups across departments and may require varying efforts to achieve improvement. Therefore, this study investigated: (1) whether distinct learning climate groups could be identified and (2) whether contextual factors could explain variation in departments' learning climate performance. Methods: This study included departments that used the Dutch Residency Educational Climate Test (D-RECT) through a web-based system in 2014-2015. Latent profile analysis was used to identify learning climate groups and multilevel modeling to predict clinical departments' learning climate performance. Results: The study included 1730 resident evaluations. Departments were classified into one of the four learning climate groups: substandard, adequate, good and excellent performers. The teaching status of the hospital, departments' average teaching performance and percentage of time spent on educational activities by faculty-predicted departments' learning climate performance. Discussion: Clinical departments can be successfully classified into informative learning climate groups. Ideally, given informative climate grouping with potential for cross learning, the departments could embark on targeted performance improvement.

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“… 6 Residency’s learning climate points to the context in which residents’ learning happens as far as the setting, shared recognitions on approaches, practices, and policies. 7 Healthy educational climate is helpful for effective learning, 3 - 5 resident wellbeing, 8 - 10 physician competency, 6 professionality, 11 and training satisfaction. 12 , 13 As an acknowledgement to the role of learning environment in improving medical education quality, several tools have been developed for its evaluation at pre- and postgraduate levels.…”

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confidence: 99%

Learning environment of the Saudi psychiatry board training program

Alshomrani

AlHadi

2017

SMJ

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Objectives:To assess the learning environment of the Saudi psychiatry board program using the Dutch Residency Educational Climate Test (D-RECT) and to explore residents’ perception of different domains of the learning environment.Methods:This was a descriptive cross-sectional study. The D-RECT instrument was distributed to all residents at all training sites of the Saudi psychiatry training program. It is a reliable and valid instrument to measure educational environment at the postgraduate level. Mean scores are presented, t-tests, analysis of variance, and post hoc analysis were used to compare subgroups and pearson’s correlation was used to assess relationships.Results:Seventy-eight out of 96 residents responded (81.25%), one third of them were female. Overall D-RECT score was 2.76±0.55. The supervision subscale scored 2.83±0.83, coaching and assessment scored 2.60±0.73, feedback scored 2.00±0.85, team work scored 2.81±0.86, peer collaboration scored 3.54±0.84, professional relations between consultants scored 2.71±0.95, work is adapted to residents’ competence scored 2.71±0.86, consultants’ attitudes scored 2.71±0.86, formal education scored 2.68±0.72, and patient handover subscales scored 3.25±1.06. Female residents scored significantly higher than their male counterparts and there were no statistical significant difference between years of residency. Cronbach’s alpha was 0.936.Conclusion:Most of the learning climate domains scored poorly, which necessitates a rigorous plan for reevaluation and improvement. Furthermore, D-RECT proved to be a reliable instrument and could help in evaluation and improvement of postgraduate training programs.

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Effect of the Learning Climate of Residency Programs on Faculty’s Teaching Performance as Evaluated by Residents

Cited by 51 publications

References 28 publications

The Struggle Is Real: How Residents Learn to Provide High-Value, Cost-Conscious Care

The Struggle Is Real: How Residents Learn to Provide High-Value, Cost-Conscious Care

From good to excellent: Improving clinical departments’ learning climate in residency training

Learning environment of the Saudi psychiatry board training program

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