96th Medical Group, Family Medicine Residency Program, Eglin Air Force Base Hospital, Eglin Air Force Base, Eglin, FL.
96th Medical Group, Department of Flight Medicine, Eglin Air Force Base Hospital, Eglin Air Force Base, Eglin, FL.
Fam Med. 2023 Nov;55(10):653-659. doi: 10.22454/FamMed.2023.239179. Epub 2023 Jul 24.
Scholarly activity is a core requirement set by the Accreditation Council for Graduate Medical Education (ACGME). A previous study documented a significant 302% increase in scholarly activity at Eglin Family Medicine Residency after implementation of a standard set of interventions from 2016 to 2019. Few researchers have explained why such interventions to increase scholarly activity are effective. Prior work has suggested that many different interventions are helpful, but why? Our qualitative study took a multilevel approach to explain accompanying cultural factors and to determine how specific interventions led to the observed increases in quality and quantity of resident scholarship.
Taking a grounded theory qualitative approach, we interviewed a cross-section of high- and low-producing residents (12) and faculty (5) using a semistructured interview guide. Data analysis occurred concurrently with interviews. The team iterated the interview guide three times until core code saturation was achieved. Then axial coding occurred, and our team developed a grounded theory of scholarship cultural change.
During the transformation period of 2016 to 2019, participants identified mentorship availability, interest/opportunity alignment, research mechanics demystification, leadership support affecting productivity, and scholarship begets scholarship as key factors that promulgated the culture change leading to increased scholarship productivity. No single factor led to increased scholarship. Collectively, they mutually reinforced one another.
This explanatory inquiry developed into a multilevel model which suggests that the synergy of promoting elements drives increased scholarly productivity. Other residencies should consider fostering these combined elements instead of emphasizing only isolated individual elements to increase resident scholarship productivity.
学术活动是研究生医学教育认证委员会(ACGME)设定的核心要求。先前的一项研究记录表明,在 2016 年至 2019 年期间实施了一套标准干预措施后,埃格林家庭医学住院医师培训计划的学术活动显著增加了 302%。很少有研究人员解释为什么这些增加学术活动的干预措施是有效的。先前的工作表明,许多不同的干预措施是有帮助的,但为什么呢?我们的定性研究采用多层面方法来解释伴随的文化因素,并确定特定干预措施如何导致居民奖学金的质量和数量的观察到的增加。
采用扎根理论定性方法,我们使用半结构化访谈指南对高产出和低产出的住院医师(12 人)和教师(5 人)进行了跨层次访谈。数据分析与访谈同时进行。团队迭代了访谈指南三次,直到达到核心代码饱和度。然后进行轴向编码,我们的团队开发了一个关于奖学金文化变革的扎根理论。
在 2016 年至 2019 年的转型期间,参与者确定了指导可用性、兴趣/机会一致性、研究机制解密、领导力支持影响生产力以及奖学金促进奖学金作为推动文化变革从而提高奖学金生产力的关键因素。没有一个单一的因素导致奖学金的增加。它们共同相互加强。
这项解释性探究发展成一个多层次的模型,表明促进因素的协同作用推动了学术生产力的提高。其他住院医师培训计划应考虑培养这些综合因素,而不是强调仅强调孤立的单个因素来提高居民奖学金的生产力。