Becoming a new doctor: a learning or survival exercise?

Brown, Jeremy; Chapman, Tom; Graham, David R.

doi:10.1111/j.1365-2929.2007.02785.x

Cited by 23 publications

(15 citation statements)

References 7 publications

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“…Given that supportive learning climates are considered to be crucial to the quality of PGME (Genn 2001a(Genn , 2001b, we recommend educational practice to include learning climate performance indicators in accreditation standards worldwide. As previous research suggests an association between supportive learning climates and the professional development of residents as caregivers (Cross et al 2006;Brown et al 2007;Dyrbye and Shanafelt 2016), the excellent performing learning climate groups identified in our results would be most desirable for clinical practice. Although it seems intuitive to advice clinical practice to put efforts in achieving excellent learning climates, a study performed by Smirnova et al (2017) warns that too much attention for learning climates may lead to impaired patient outcomes.…”

Section: Implications For Educational and Clinical Practicementioning

confidence: 55%

“…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. It follows that highquality learning climates are of paramount importance to both residents and patients.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Implications For Educational and Clinical Practicementioning

confidence: 55%

Section: Introductionmentioning

confidence: 99%

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

et al. 2017

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“…of residents with a larger group of clinical supervisors, instead of the single master-apprentice interaction, and the recognition that medical knowledge and skills need to be supplemented by other competencies, such as communication and professionalism, has led to a reorientation of theoretical perspectives on residency learning; notably, the emergence of socio-cultural as well as cognitive accounts of learning (Bleakley 2002;Brown et al 2007). …”

Section: Theoretical Perspectives On Residency Educationmentioning

confidence: 99%

Experiential learning: AMEE Guide No. 63

2012

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This Guide provides an overview of educational theory relevant to learning from experience. It considers experience gained in clinical workplaces from early medical student days through qualification to continuing professional development. Three key assumptions underpin the Guide: learning is 'situated'; it can be viewed either as an individual or a collective process; and the learning relevant to this Guide is triggered by authentic practice-based experiences. We first provide an overview of the guiding principles of experiential learning and significant historical contributions to its development as a theoretical perspective. We then discuss socio-cultural perspectives on experiential learning, highlighting their key tenets and drawing together common threads between theories. The second part of the Guide provides examples of learning from experience in practice to show how theoretical stances apply to clinical workplaces. Early experience, student clerkships and residency training are discussed in turn. We end with a summary of the current state of understanding.

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“…A series of research papers, furthermore, highlights the dynamic between medical resident and teacher from the perspective of mentorship (Donovan & Donovan, 2009;Jeffries & Skidmore, 2010;Kilminster & Jolly, 2000' Memon & Memon, 2010Oelschlager, Smith, Tamura, Carline, & Dobie, 2011;Stamm & Buddeberg-Fischer, 2011). Lastly, it is worthwhile to note that this stream of literature also explores the socialization process inherent within the workplace (Hafferty & Hafler, 2011), as residents learn to 'become' practicing physicians (Bleakley, 2011;Brown, Chapman, & Graham, 2007;Foster, 2011) and develop their professional identities (Bleakley, 2011b;Burford, 2012;Helmich & Dornan, 2012) and ways of being (Dall'Alba, 2009). …”

Section: The Medical Contextmentioning

confidence: 99%

“…This is especially relevant given the continual expansion of knowledge developed through medical, clinical and educational science and the application of technology within the context of medicine, particularly within PGME. It has been suggested that becoming a new physician is a survival exercise (Brown et al, 2007). While this is an interesting idea, this mostly relates to the notion of entering the profession, rather than acknowledging the longitudinal aspect of sustaining a career of becoming and being a physician.…”

Section: Instances Of Critical Learning Are Varied and Personalmentioning

confidence: 99%

Stories of becoming an emergency medicine physician

Hussain¹

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There exists a large output of empirical research and numerous calls for reform in medical education (Cooke et al., 2010;Frenk et al., 2010). Relatively little of this research, however, to the best of our knowledge, focuses on the professional learning practices within medical education, particularly within the context of post-graduate medical education or PGME (Van de Wiel, et al., 2011;Van der Zwet et al., 2011). To this end, it is important that medical educators, administrators, and practicing Attending physicians are provided with a clear understanding of the professional learning environment of current medical Residents, the teaching methods used by Attending physicians and ultimately, the unique milestones, instances of critical learning, and the transitions within the learning process of specializing within a particular medical residency. The rationale, therefore, for this study was to attempt to fulfil some of the calls for further investigation into PGME in a gainful attempt to This thesis provides novel insight into how 'learning to become' occurs within PGME and specifically, within the context of emergency medicine. Due to the large volume of data gathered during the interview and observation process, the findings of this study were divided by focusing one chapter on the Residents (chapter 4) and the subsequent chapter focused on the Attending physicians (chapter 5). For the Residents, the nature of their learning was iii characterized by a struggle for autonomy while establishing an identity as a physician.Findings from the Residents also focused on how they managed themselves within the residency process by handling multiple relationships, learning from mistakes and debriefing, engaged in informal teaching, utilized technology, and were involved with transitions as impactful learning experiences during residency.Findings from the Attending physicians suggest that the residency process was an opportunity to specialize within a chosen field of practice while being able to consolidate knowledge and work in a clinical environment. The findings from the Attending physicians, moreover, suggest that impactful learning is often facilitated by 'important others' who are often involved with teaching and mentoring. Perspectives are also shared on the use of media and technology in practice. Lastly, the Attending physicians describe transitions as impactful learning experiences, particularly as they exited residency and practiced as fully qualified practitioners.Revisiting the research questions, the lived experience of the participants can be summarized into four major discussion points; 1) learning in emergency medicine involves dynamic changes in identity, 2) learning experiences are highly structured, but are informal in practice, 3) mentorship is critical in medical residency, and 4) instances of critical learning are varied and personal. The implications of the participants lived experience 'learning to become' practicing emergency physicians, led to both pedagogical and methodological recommen...

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Becoming a new doctor: a learning or survival exercise?

Cited by 23 publications

References 7 publications

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

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

Experiential learning: AMEE Guide No. 63

Stories of becoming an emergency medicine physician

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