Unravelling underlying processes in intraprofessional workplace learning in residency

Background: 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.Method: 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.Results: 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.Conclusions: 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.

Automated summary

This study aimed to gain insight into the processes of intraprofessional workplace learning among residents in residency training, by exploring everyday interactions between residents from different medical specialties. Through observations and interviews, it was found that residents are actively engaged in numerous intraprofessional interactions, with key themes including residents' agency, ingroups and outgroups, and communication about intraprofessional collaboration. The role of the resident-supervisor dyad was emphasized in facilitating residents' engagement in learning opportunities for complex intraprofessional care. Promoting deliberate practice and shared responsibility in collaborative care were proposed as crucial for better preparing residents for their roles in delivering high-quality collaborative patient care.