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A Qualitative Study of Senior Residents' Learning Strategies to Prepare for Unsupervised Practice
Introduction: As emergency medicine (EM) residents prepare for the transition into unsupervised practice, their focus shifts from demonstrating competencies within familiar training environments to anticipating their new roles and responsibilities as attending physicians, often in unfamiliar settings. Using the self-regulated learning framework, we explored how senior EM residents proactively identify goals and enact learning strategies leading up to the transition from residency into unsupervised practice. Methods: In this study we used a constructivist grounded theory approach, interviewing EM residents in their final year of training at two residency programs. Using the self-regulated learning framework as a sensitizing concept for analysis, we conducted inductive, line-by-line coding of interview transcripts and grouped codes into categories. Theoretical sufficiency was reached after 12 interviews, with four subsequent interviews producing no divergent or disconfirming examples. Results: We interviewed16 senior residents about their self-regulated learning approaches to preparing for unsupervised practice. Participants identified two types of gaps that they sought to address prior to entering practice: knowledge/skill gaps, and autonomy gaps. We employed specific workplace learning strategies to address each type of gap, which we have termed cherry-picking, case-based hypotheticals, parachuting, and making the call, and reflection on both internal and external sources of feedback to assess the effectiveness of these learning strategies. This study presents participants’ identification of gaps in their residency training, their learning strategies, and reflections as cyclical processes of self-regulated learning. Conclusion: In their final months of training EM residents strategically leverage learning strategies to bridge gaps between their self-assessed capabilities and those they anticipate needing to succeed in unsupervised practice. These findings show that trainees have agency in how they use goal setting, strategic actions, and ongoing reflection to prepare themselves for unsupervised practice. Our findings also suggest tailored approaches whereby programs can support learning experiences that foster senior residents’ agency when preparing for the challenges of future practice.
Journal Article
Lunch with the FT : a second helping
'Lunch with the Financial Times' has been a permanent fixture in the Financial Times for almost 25 years, featuring presidents, film stars, musical icons and business leaders from around the world. The column is now as well-established institution which has reinvigorated the art of conversation in the convivial, intimate environment of a long boozy lunch. On its 25th anniversary, this book showcases the most entertaining, incisive and fascinating interviews from the past five years including those with Edward Snowden, Bernie Ecclestone, Hilary Mantel, Sheryl Sandberg, Richard Branson, Rebecca Solnit, Emmerson Mnangagwa, Jordan Peterson, Nigel Farage, Woody Harrelson, Sepp Blatter, (pre-election) Donald Trump and Zoella, illustrated in full colour with James Ferguson's famous portraits.
Book
