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Residents build trust in interns based on intern characteristics like reliability and competence, alongside contextual factors such as electronic medical records and duty hours. This trust is crucial for safe patient care delivery in complex hospital settings.

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Area of Science:

  • Medical Education
  • Healthcare Management
  • Patient Safety

Background:

  • Physician residents rely on interns for patient care.
  • Understanding the formation of trust between residents and interns is essential for effective teamwork and patient safety.
  • Limited research exists on the specific factors influencing this trust dynamic.

Purpose of the Study:

  • To investigate how internal medicine residents develop trust in interns.
  • To identify key factors influencing the formation of resident trust in interns.
  • To develop a model explaining the process of trust development in this hierarchical relationship.

Main Methods:

  • A multi-institutional mixed-methods study combining qualitative interviews and quantitative surveys.
  • Grounded theory analysis of 29 resident interviews to develop an initial trust model.
  • Survey testing of the model with 376 residents across five internal medicine programs.

Main Results:

  • Qualitative analysis identified 14 themes within five core trust factors (resident, intern, relationship, task, context).
  • Quantitative survey revealed 11 factors influencing trust, with intern characteristics (reliability, competence) and contextual factors (EMR access, duty hours) rated highly.
  • Intern reliability (mean 86.3) and competence (mean 76.4) were paramount for trust formation.

Conclusions:

  • Resident trust in interns is primarily shaped by intern-specific attributes and the surrounding healthcare context.
  • Residents prioritize interns' ability to perform essential patient care tasks safely amidst hospital complexities.
  • The findings underscore the importance of intern reliability and supportive contextual elements in fostering inter-physician trust.