Program directors’ perceptions of teaching strategies to foster socialization in residents

Background The transition from student to doctor is not only a ceremonious occasion but also a challenging step for recently graduated doctors and their supervisors. The magnitude of this challenge is illustrated by the gap between programs directors’ expectations and new residents’ performance, specifically; there might be mismatch between knowledge and experience acquired during medical school and what is needed to work effectively as a starting young doctor. In organizational psychology, ‘what needs to be learned as newcomer in an organization’ is called ‘onboarding’ or ‘newcomer adjustment’. This falls within a larger process of organizational socialization. Daily supervisors observe this process in the hospital and that is why we ask them: what do recently graduated doctors learn in their role as doctor in the hospital as organization? Summary of work Semi-structured interviews were conducted with 17 supervisors from different specialties and hospitals (academic, non-academic teaching) in the Netherlands. A thematic analysis approach was used to identify the learning content of newcomers. After themes emerged, we compared it with the 6 dimensions Chao described in organizational socialization. Summary of results Six themes were identified that characterized the learning content of recently graduated doctors working in a hospital; “performance proficiency” entails the knowledge and skills needed to successfully perform specialty-specific tasks. Learning the “organization and logistics” is a time-consuming task in the beginning. Certain “behavior” is expected from the newcomer and they will receive feedback if they don’t behave as expected. “Personal development” entails the growth of the newcomer, influenced by medical content. Collaboration with other health care workers, which acquires knowledge of formal and informal relationships, is called “people”. The specialty- and hospital-specific communication is covered by “language”. Discussion / conclusion Entry into a hospital as organization for doctors as newcomers is a critical time as they learn to adjust to their new environment. The content of this learning process entails besides gaining in-depth knowledge of medical content, also knowledge which is needed as doctor in the hospital as organization. Take home message While medical school prepares for in-depth knowledge and skills in the medical domain, knowledge performing as doctor in the hospital as organization is needed to perform effectively as recently graduated doctor.