Alejandro R Perez1, Christy K Boscardin2, Manuel Pardo2. 1. is a PGYA Resident Physician in the Department of Emergency Medicine at Loma Linda University Medical Center, Loma Linda, CA. 2. is a Professor; is a Professor in the Department of Anesthesia and Perioperative Care at the University of California, San Francisco, CA and is also in the Department of Medicine and Department of Anesthesia and Perioperative Care.
Abstract
Background: The transition from internship to residency can be a particularly stressful time for learners, adversely affecting residents' experience of training. Despite awareness of residents' stress during transitions, there is limited information available regarding how residents perceive these transitions or how they could be improved. We explored residents' accounts of the experience of transitioning from internship to residency to develop a better understanding of their challenges and recommended strategies for interventions. Methods: We conducted semistructured interviews with first-year anesthesia residents at the University of California, San Francisco. We conducted a thematic analysis through a general inductive approach on transcribed interviews. Results: Ten residents, evenly split among categorical and noncategorical residents, participated in the interviews. We identified seven challenges faced by residents during the transition, including cognitive load management, self-assessment and eliciting effective feedback, learning resource utilization, preoperative care planning and discussion, forming relationships with peers and faculty, and professional identity formation. Residents also recommended strategies to address these challenges, including early low-stake exposure to complex cases, standardized feedback structure, resource utilization guides, normalization of discussing errors with peers, and protected time for networking events. Conclusion: Residents face multiple challenges at the personal, social, and structural levels during the transition. Their recommended strategies are actionable, including scaffolded learning opportunities with increasing difficulty, more standardized and structured communications around expectations and effective feedback, enhanced orientation through bootcamp, and integration of more formal and informal social networking opportunities to increase peer and faculty interaction.
Background: The transition from internship to residency can be a particularly stressful time for learners, adversely affecting residents' experience of training. Despite awareness of residents' stress during transitions, there is limited information available regarding how residents perceive these transitions or how they could be improved. We explored residents' accounts of the experience of transitioning from internship to residency to develop a better understanding of their challenges and recommended strategies for interventions. Methods: We conducted semistructured interviews with first-year anesthesia residents at the University of California, San Francisco. We conducted a thematic analysis through a general inductive approach on transcribed interviews. Results: Ten residents, evenly split among categorical and noncategorical residents, participated in the interviews. We identified seven challenges faced by residents during the transition, including cognitive load management, self-assessment and eliciting effective feedback, learning resource utilization, preoperative care planning and discussion, forming relationships with peers and faculty, and professional identity formation. Residents also recommended strategies to address these challenges, including early low-stake exposure to complex cases, standardized feedback structure, resource utilization guides, normalization of discussing errors with peers, and protected time for networking events. Conclusion: Residents face multiple challenges at the personal, social, and structural levels during the transition. Their recommended strategies are actionable, including scaffolded learning opportunities with increasing difficulty, more standardized and structured communications around expectations and effective feedback, enhanced orientation through bootcamp, and integration of more formal and informal social networking opportunities to increase peer and faculty interaction.
Authors: David R Taylor; Yoon Soo Park; Christopher A Smith; Jolanta Karpinski; William Coke; Ara Tekian Journal: Ann Intern Med Date: 2018-04-17 Impact factor: 25.391
Authors: John Raimo; Sean LaVine; Kelly Spielmann; Meredith Akerman; Karen A Friedman; Kyle Katona; Saima Chaudhry Journal: J Grad Med Educ Date: 2018-10