University of Groningen, University Medical Center Groningen, Department of Anesthesiology, Groningen, the Netherlands.
University of Groningen, University Medical Center Groningen, Center for Education Development and Research in health professions (CEDAR), Lifelong Learning, Education and Assessment Research Network (LEARN), Groningen, the Netherlands.
BMC Med Educ. 2022 Apr 5;22(1):247. doi: 10.1186/s12909-022-03315-9.
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.
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.
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.
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.
许多住院医师在从医学生转变为住院医师的过程中，都经历了困难和压力。他们面临的挑战是双重的：既要应对任务或职责的变化，又要承担（新的）社会角色。这个“熟悉情况”的过程被称为组织社会化（OS）。尽管有大量关于从住院医师角度看待过渡的文献，但促进和指导住院医师完成组织社会化过程的项目主任（PDs）的观点尚未得到探索。PDs 的观点很重要，因为 PDs 负责毕业后医学教育（PGME），并直接或间接地促进住院医师的社会化过程。我们从 OS 的角度探讨了 PDs 采用哪些策略来促进新住院医师的组织社会化。
我们对来自不同专业的 17 名 PD 进行了半结构化访谈。我们采用了理论启发式归纳数据分析研究设计，包括归纳主题分析、通过 OS 镜头对结果进行演绎解释，以及随后进行归纳分析以确定总体见解。
我们确定了 PDs 用于促进新住院医师组织社会化的六种策略，并揭示了两个总体见解。首先，PDs 在指导的计划性程度上存在差异。一些 PD 将社会化作为明确的学习目标进行规划，并相应地分配住院医师的任务和职责，使其成为预期的项目成果。然而，社会化也通过工作场所的社交互动来促进，使其成为非预期的项目成果。其次，PDs 在适应新住院医师的策略方面存在差异。一些 PD 使用针对个别住院医师需求和技能的个体化策略，特别是在表现不佳的情况下，通过提出并讨论问题或调整任务和职责来实现。然而，PDs 也使用要求住院医师适应工作场所而无需过多干预的工作场所策略，这通常被视为一种隐含的期望。
PDs 使用了有意和无意的策略来促进住院医师的社会化，这可能意味着社会化可以在没有 PD 策略的情况下发生。PDs 的策略从以个体为中心到以工作场所为中心的社会化方法各不相同。需要进一步研究，以更深入地了解住院医师对 PD 促进他们在过渡期间社会化过程的努力的看法。
