Identifying factors that influence workplace learning in postgraduate medical education.

CONTEXT: In their postgraduate educational programs, residents are immersed in a complex workplace. To improve the quality of the training program, it is necessary to gain insight into the factors that influence the process of learning in the workplace.
METHODS: An exploratory study was carried out among 56 nursing home physicians in training (NHPT) and 62 supervisors. They participated in semi-structured group interviews, in which they discussed four questions regarding workplace learning. Qualitative analysis of the data was performed to establish a framework of factors that influence workplace learning, within which framework comparisons between groups could be made.
RESULTS: A framework consisting of 56 factors was identified. These were grouped into 10 categories, which in turn were grouped into four domains: the working environment, educational factors in the workplace, NHPT characteristics and supervisor characteristics. Of the factors that influence workplace learning, social integration was cited most often. Supervisors more often reported educational factors and NHPTs more frequently reported impediments.
CONCLUSION: The educational relationship may be improved when supervisors explicitly discuss the learning process and learning conditions within the workplace, thereby focusing on the NHPT needs. Special attention should be paid to the aspects of social integration. A good start could be to answer the question regarding how to establish a basic feeling of 'knowing where you are' and 'how to go about things' to make residents feel comfortable enough to focus on the learning process.