Department of Pediatrics, Radboud University Medical Center, Radboudumc Amalia Children's Hospital, Nijmegen, the Netherlands.
Department of Research on Learning and Education, Radboud University Medical Center, Radboudumc Health Academy, Nijmegen, the Netherlands.
Med Educ. 2024 Aug;58(8):939-951. doi: 10.1111/medu.15271. Epub 2023 Nov 22.
To deliver high-quality collaborative care, residents need to be trained across the boundaries of their medical specialty (intraprofessional learning). The current literature does not provide insights into the underlying processes that influence intraprofessional learning. The aim of this study was to gain insight into the processes that occur during intraprofessional workplace learning in residency training, by exploring everyday intraprofessional interactions experienced by residents, with the ultimate objective of improving collaborative practice.
We conducted a focused ethnography using field observations and in-depth interviews with residents at an academic children's hospital in the Netherlands. In 2022, nine residents from four different medical specialties were shadowed and/or interviewed. In total, >120 hours of observation and 10 interviews were conducted. Data collection and analysis were conducted iteratively and discussed in a research team with diverse perspectives, as well as with a sounding board group of stakeholders.
Residents were involved in numerous intraprofessional interactions as part of their daily work. We identified three themes that shed light on the underlying processes that occur during intraprofessional workplace learning: (1) residents' agency, (2) ingroups and outgroups and (3) communication about intraprofessional collaboration.
Collaborative practice offers many intraprofessional learning opportunities but does not automatically result in learning from, with and about other specialties to improve intraprofessional collaborative care. Overarching the identified themes, we emphasise the pivotal role of the resident-supervisor dyad in facilitating residents' engagement in the learning opportunities of complex intraprofessional care. Furthermore, we propose that promoting deliberate practice and shared responsibility in collaborative care are crucial to better prepare residents for their roles and responsibilities in delivering high-quality collaborative patient care.
为了提供高质量的协作式护理，住院医师需要跨医疗专业领域接受培训（专业内学习）。目前的文献并未深入探讨影响专业内学习的潜在过程。本研究旨在深入了解住院医师培训中专业内工作场所学习过程中发生的情况，通过探索住院医师日常专业内互动，最终目标是改善协作实践。
我们在荷兰的一家学术儿童医院进行了一项聚焦民族志研究，使用现场观察和对住院医师的深入访谈。2022 年，对来自四个不同医学专业的九名住院医师进行了跟踪观察和/或访谈。总共进行了>120 小时的观察和 10 次访谈。数据收集和分析是迭代进行的，并在一个具有不同观点的研究团队中以及在利益相关者的共鸣小组中进行了讨论。
住院医师在日常工作中参与了许多专业内互动。我们确定了三个主题，这些主题阐明了在专业内工作场所学习过程中发生的潜在过程：（1）住院医师的能动性，（2）内群体和外群体，以及（3）关于专业内合作的沟通。
协作实践提供了许多专业内学习机会，但并不一定会自动促进从其他专业学习，与其他专业合作以改善专业内协作护理。在确定的主题中，我们强调了住院医师-主管对偶在促进住院医师参与复杂专业内护理学习机会中的关键作用。此外，我们提出，促进协作式护理中的刻意练习和共同责任对于更好地培养住院医师在提供高质量协作式患者护理方面的角色和责任至关重要。
