Using focus groups to understand causes for morale decline after introducing change in an IM residency program

Area of Science:

• Medical Education Research
• Qualitative Research Methods

Background:

• Program evaluation is crucial for Internal Medicine residencies, yet resident satisfaction data is scarce.
• Traditional numerical rating scales offer limited insight into specific dissatisfaction drivers.

Purpose of the Study:

• To assess the effectiveness of focus group methodology in identifying reasons for declining resident morale.
• To gather resident-generated suggestions for improving the training environment.

Main Methods:

• A qualitative research design utilizing focus groups (FG) informed by quantitative survey data.
• Forty 2nd and 3rd-year Internal Medicine residents participated in five focus groups.
• Focus groups explored factors contributing to decreased morale, guided by chief residents.

Main Results:

• Residents identified the pace and process of change, the role of chief residents, and fear of intimidation/retaliation as primary morale detractors.
• Practical recommendations for enhancing the residency culture were proposed.

Conclusions:

• Implementing change in residency programs requires careful consideration of resident feedback.
• Focus groups effectively uncover specific resident concerns and facilitate solution-oriented discussions.
• Focus group methodology is adaptable for comprehensive residency program evaluation.