It is the Unknown That Matters: Program Directors' Perspectives on Information Gaps in Learner Educational Handovers

Area of Science:

• Medical Education Research
• Graduate Medical Education
• Trainee Support Systems

Background:

• The transition to residency presents significant challenges for trainees and educators.
• Existing learner educational handovers have shown varied success, with limited understanding of misalignment between trainee needs and support.

Purpose of the Study:

• To explore program directors' (PDs') experiences with residents facing difficulties during their transition to residency.
• To identify what information might have better prepared educators to support struggling residents.

Main Methods:

• A constructivist grounded theory approach within an interpretivist paradigm was employed.
• Virtual semistructured interviews were conducted with 19 PDs from diverse medical specialties in the Western United States.
• Thematic analysis and constant comparison were used to interpret 38 narratives of residents' workplace adaptation difficulties.

Main Results:

• PDs found it challenging to interpret information from applications to anticipate resident struggles.
• A significant amount of desired information was perceived as either currently unknown (not routinely gathered) or currently unknowable (undetectable until residency).

Conclusions:

• A novel conceptual model suggests strategies for making ambiguous or unknown information more accessible to postgraduate programs.
• Generating currently unknowable information requires innovation, and systematic efforts are needed for effective learner educational handovers.