How do programme directors perceive trainee attrition? A qualitative focus group study in three Dutch teaching...

Area of Science:

• Medical Education Research
• Postgraduate Training
• Healthcare Professional Development

Background:

• Trainee attrition from postgraduate medical education (PGME) presents challenges to healthcare systems.
• Understanding programme directors' (PDs') perspectives is crucial for developing effective retention strategies.

Purpose of the Study:

• To explore PDs' perceptions of trainee attrition in PGME.
• To identify factors contributing to attrition, including stakeholder interactions and PD roles.
• To understand the PD's role in the attrition process.

Main Methods:

• Focus group study involving 27 PDs from three Dutch teaching hospitals.
• Qualitative analysis of transcripts using template analysis.

Main Results:

• Attrition is perceived as a multilevel problem (personal, workplace, system-bound factors).
• Key trainee factors include balancing professional/personal responsibilities (parenthood, ambitions).
• PDs experience role conflict (assessor vs. mentor) and emotional responses to attrition.
• Support for trainees is often reactive; generational differences in work-life balance impede understanding.
• Systemic issues like implicit beliefs and negative interactions impact trainee well-being.

Conclusions:

• Trainee attrition is a complex, multilevel issue impacting PDs' roles and emotions.
• Proposed interventions include reallocating PD tasks, proactive non-assessment support, raising awareness of assumptions, and fostering a supportive learning climate.