Dealing with the extraordinary: how a community of practice supports resident training during the COVID-19 pandemic and beyond.

BACKGROUND

The practice of medicine occurs within a community of practice (CoP), where learning is shaped through shared purpose, the interaction of members, and the development of collective knowledge and skills. Through experiential learning, medical trainees become healthcare professionals within this community. The COVID-19 pandemic disrupted traditional training models, requiring residents to adapt under extraordinary circumstances. This study applies a CoP lens to explore how residency program directors (PD) perceived residents' learning, competence development, and adaptation during the pandemic.

METHODS

A qualitative analysis was conducted on PD's written responses to a COVID-19 survey administered by the Accreditation Council for Graduate Medical Education-International from July 1 to September 30, 2020. De-identified narrative reflections on the pandemic's impact on clinical learning environments and training experiences were analyzed using thematic content analysis.

RESULTS

Responses from 138 PDs in six countries were analyzed. Three themes emerged, highlighting the social and dynamic nature of experiential learning in a CoP: (1) capability building, where residents adapted by integrating and applying knowledge, skills, and attitudes as modeled by faculty and peers; (2) fostering resilience in the face of uncertainty through altruism, volunteerism, strong support networks, and collective moral resilience; and (3) collaborative working and communicating across interdisciplinary and interprofessional teams, facilitated by a flattening of traditional hierarchies.

CONCLUSIONS

Support from senior physicians and a shared sense of purpose facilitated residents' learning in a rapidly changing, high stakes environment. This accelerated experiential learning occurred through engagement within a CoP. Our findings illustrate how the CoP framework can help residency programs foster adaptive learning and resilience during future large-scale disruptions to medical training.