Learning to doctor: tinkering with visibility in residency training

Area of Science:

• Medical Education
• Sociology of Health and Illness
• Surgical Training

Background:

• Teaching hospitals balance patient care with resident training.
• Medical training traditionally requires resident "invisibility" for practice.
• Current reforms emphasize measurable resident visibility.

Purpose of the Study:

• To explore the coexistence of multiple resident "visibilities" in daily clinical practice.
• To understand how attending physicians and residents manage these visibilities.
• To analyze the impact of new technologies on clinical training.

Main Methods:

• Ethnographic study of gynaecology training in The Netherlands.
• Observation of daily clinical routines and interactions.
• Analysis of practices related to resident visibility.

Main Results:

• Four distinct practices of resident visibility were identified: staging, negotiating supervision, invisibility games, and filming operations.
• Clinicians actively "tinker" with these visibilities to balance care and learning.
• Visualizing technologies play an increasing role in clinical work and training.

Conclusions:

• Medical training involves a dynamic interplay of different "visibilities."
• Focusing on the practices of medical training offers insights into navigating reform challenges.
• Understanding these practices is crucial for effective postgraduate medical education.