Related Experiment Videos
How do residents learn? The development of practice styles in a residency program
Paul J Chung1, Jeanette Chung, Manish N Shah
1Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, California 90095, USA. paul-chung@mednet.ucla.edu
Summary
Resident interactions during training correlate with similar practice styles. Increased time spent rotating together led to greater practice similarity, with gender dynamics influencing this effect in medical education.
Area of Science:
- Medical Education
- Clinical Practice Patterns
- Social Dynamics in Learning
Background:
- Practice variations in residency programs can impact patient care.
- Understanding factors influencing resident practice styles is crucial for medical education.
- Interpersonal dynamics may play a role in shaping future physician behaviors.
Purpose of the Study:
- To investigate if resident interactions during rotations influence learning and practice styles.
- To determine the association between shared rotation time and similarity in clinical decision-making.
- To explore the role of resident pair gender composition in practice style convergence.
Main Methods:
- Pediatric residents completed vignette surveys on practice styles for fever and asthma.
- Propensities for testing, treatment, and diagnosis were measured.
- Statistical analysis examined the association between shared rotation months and practice similarity, controlling for demographics and learning styles.
- The influence of gender mix within resident pairs was assessed.
Main Results:
- Practices varied significantly among residents, even within the same training year.
- Each additional month residents rotated together increased the likelihood of similar practice propensities (fever testing: 1.22x, asthma diagnosis: 1.30x).
- Associations between shared rotations and practice similarity were stronger for opposite-sex resident pairs compared to same-sex pairs.
Conclusions:
- Practice variations are evident within residency programs and can emerge within a single academic year.
- Increased collaboration among residents leads to more similar practice styles.
- Interpersonal dynamics, particularly influenced by gender composition, are important factors in resident learning and practice convergence, with implications for medical education and quality improvement.