Learning on the Fly: A Qualitative Study Exploring Workplace Experiences That Contribute to Residents' Development as...

Background While residents play a critical role as teachers in the clinical learning environment, knowledge of how they develop the necessary skills to teach and how graduate medical education programs can support their development as teachers remains limited. Objective This study aims to use the pedagogical content knowledge framework to explore how residents' workplace-based experiences influence their development as clinical teachers. Methods This qualitative study used focus groups and semistructured interviews with senior residents across departments of emergency medicine, general surgery, and internal medicine at the University of California, San Francisco. We used purposive sampling to recruit participants. Twenty-five residents agreed to participate. We interviewed participants based on availability and ceased data collection when we stopped identifying new concepts. We conducted 2 focus groups and 13 interviews with 18 participants, with data collection occurring between July 2023 and March 2024. The authors used thematic analysis with pedagogical content knowledge as a sensitizing concept to identify themes. Results The authors identified 3 themes characterizing how residents learn to teach through their workplace-based experiences: learning from being a learner, developing teaching skills through experience, and gathering and responding to feedback. The process of residents' development as teachers was largely similar across all 3 specialties. Differences in the specific experiences that shaped residents' development were influenced by specialty-specific workplace demands and differences in practice contexts. Conclusions Residents' development as clinical teachers occur through the integration of their experiences as learners, expanding clinical and teaching expertise, and feedback and reflection on their ongoing teaching practice.