Introduction: Understanding residents' workplace learning could be optimized by not only considering attending physicians' role but also the role of nurses. While previous studies described nurses' role during discrete activities (e.g. feedback), a more profound understanding of how nurses contribute to residents' learning remains warranted. Therefore, we used the educational concept of guidance and explored the extent to which residents' and nurses' perceptions align regarding nurses' guiding role and which reasons they provide for their perceptions.Methods: This mixed-method study was conducted at four Dutch university medical centres in 2021. We simultaneously collected quantitative and qualitative data from 103 residents and 401 nurses through a theory-informed questionnaire with a Likertscale and open-ended questions. We analyzed quantitative data to explore respondents' perceptions of nurses' guiding role by using ANOVA. The thematically analyzed qualitative open comments explored respondents' reasons for their perceptions. Results: Nurses indicated to provide significantly more support (p = .01) and guidance on learning from patient care (p < .01) than perceived by residents. Moreover, Previous presentations Preliminary results were presented at the Association of Medical Education in Europe (AMEE) (online).

Background Many residents experience their transitions, such as from medical student to resident, as demanding and stressful. The challenges they face are twofold: coping with changes in tasks or responsibilities and performing (new) social roles. This process of ‘learning the ropes’ is known as Organizational Socialization (OS). Although there is substantial literature on transitions from the perspective of residents, the voices of program directors (PDs) who facilitate and guide residents through the organizational socialization process have not yet been explored. PDs’ perspectives are important, since PDs are formally responsible for Postgraduate Medical Education (PGME) and contribute, directly or indirectly, to residents’ socialization process. Using the lens of OS, we explored what strategies PDs use to facilitate organizational socialization of newcomer residents. Methods We conducted semi-structured interviews with 17 PDs of different specialties. We used a theory-informing inductive data analysis study design, comprising an inductive thematic analysis, a deductive interpretation of the results through the lens of OS and, subsequently, an inductive analysis to identify overarching insights. Results We identified six strategies PDs used to facilitate organizational socialization of newcomer residents and uncovered two overarching insights. First, PDs varied in the extent to which they planned their guidance. Some PDs planned socialization as an explicit learning objective and assigned residents’ tasks and responsibilities accordingly, making it an intended program outcome. However, socialization was also facilitated by social interactions in the workplace, making it an unintended program outcome. Second, PDs varied in the extent to which they adapted their strategies to the newcomer residents. Some PDs used individualized strategies tailored to individual residents’ needs and skills, particularly in cases of poor performance, by broaching and discussing the issue or adjusting tasks and responsibilities. However, PDs also used workplace strategies requiring residents to adjust to the workplace without much intervention, which was often viewed as an implicit expectation. Conclusions PDs’ used both intentional and unintentional strategies to facilitate socialization in residents, which may imply that socialization can occur irrespective of the PD’s strategy. PDs’ strategies varied from an individual-centered to a workplace-centered approach to socialization. Further research is needed to gain a deeper understanding of residents’ perceptions of PD’s efforts to facilitate their socialization process during transitions.

Background Despite the widespread use of preparation courses, residents still experience the transition from student to resident as problematic and stressful. Although this transition highly depends on the organization residents work for, only a few studies address individual and organizational strategies that help them adapt. We need this information to optimize transitions and improve onboarding programs and faculty development initiatives. This study explores residents’ experiences with their own and other health care professionals’ strategies to help them adapt to residency, and residents’ perceptions of the impact of other health care professionals’ strategies on their own adaptation efforts.Methods We conducted a qualitative interview study with 16 residents from different hospital-based specialties in the Netherlands. To identify residents’ perceptions of their own and other healthcare professionals’ strategies, we used a template analysis based on the individual and organizational tactics originating from the theory of Organizational Socialization. In this study, we defined other healthcare professionals as residents, supervisors, nurses and advanced practice providers.Results Residents experienced five individual and six organizational strategies. When engaging in social interaction with other healthcare professionals, residents used individual strategies such as asking questions and establishing social relationships to learn how to behave in their roles as doctors and members of the healthcare team. They experienced different strategies from other healthcare professionals, which we clustered into interactional (between healthcare professionals and residents) and systemic strategies (functioning of the system around residents’ training program). These strategies facilitated or hindered residents’ own adaptation efforts. We found differences in perceptions of whether a specific strategy was facilitating or hindering. Some residents, for example, perceived the lack of a role model as facilitating, while others perceived it as hindering.Conclusion Residents felt that smooth transitions require strategic approaches from both residents and other healthcare professionals. They used individual strategies to learn how to perform new tasks, behave appropriately and understand their roles in relation to those of other healthcare professionals. We distinguished interactive and systemic organizational strategies. Organizational strategies positively or negatively affected residents’ own adaptation efforts. We found differences in perceptions of whether specific organizational strategies worked, depending on residents’ individual needs.