Objectives Postgraduate trainee selection is a high-stakes process. While many studies focused on selection methods and psychometrics, little is known about the influence of selectors' personal... Show moreObjectives Postgraduate trainee selection is a high-stakes process. While many studies focused on selection methods and psychometrics, little is known about the influence of selectors' personal values and beliefs in the judgment and decision-making process. A better understanding of these factors is vital since selectors determine the future workforce. Methods We interviewed programme directors (PDs) from 11 specialties in one University Hospital. Thematic analysis was conducted with a combined approach of generic and in-vivo coding. Results PDs value excellence, 'fit' and personal characteristics. The content of these values are subject to personal interpretation and differ between PDs. PDs use various 'proxies' as alternative indicators of performance. They consider intuition, teamwork and autonomy important in judgement and decision-making. PDs find selection challenging and feel great accountability towards candidates and society. Conclusions Selectors criteria of judgement- and decision-making often remain implicit and focus on prior achievements and 'fit' with the current trainee-pool, possibly compromising the workforce's diversity. Implicit 'proxies' and intuitive decision-making may be an unwitting source of judgemental bias. 'Making the implicit explicit', by increasing awareness of personal values and beliefs and structuring the selection interview, may improve the quality of trainee selection. Show less
Bustraan, J.; Dijkhuizen, K.; Velthuis, S.; Post, R. van der; Driessen, E.; Lith, J.M.M. van; Beaufort, A.J. de 2019
Objective To gain insight into factors involved in attrition) from) hospital-based medical specialty training and future career plans of trainees who prematurely left their specialty training... Show moreObjective To gain insight into factors involved in attrition) from) hospital-based medical specialty training and future career plans of trainees who prematurely left their specialty training programme.Design Nationwide online survey study.Setting Postgraduate education of all hospital-based specialties in the Netherlands.Participants 174 trainees who prematurely left hospital-based medical specialty training between January 2014 and September 2017.Main outcome measures Factors involved in trainees' decisions to leave specialty training and their subsequent career plans.Results The response rate was 38 /0. Of the responders, 25% left their programme in the first training year, 50% in year 2-3 and 25% in year 4-6. The most frequently reported factors involved in attrition were: work-life balance, job content, workload and specialty culture. Of the leaving trainees, 66% switched to another specialty training programme, of whom two-thirds chose a non-hospital -based training programme. Twelve per cent continued their career in a non-clinical role and the remainder had no specific plans yet.Conclusions This study provides insight in factors involved in attrition and in future career paths. Based on our findings, possible interventions to reduce attrition are: (1) enable candidates to develop a realistic view on job characteristics and demands, prior to application; (2) provide individual guidance during specialty training, with emphasis on work-life balance and fit with specialty. Show less
Background: Current postgraduate medical training programmes fall short regarding residents' development of generic competencies (communication, collaboration, leadership, professionalism) and... Show moreBackground: Current postgraduate medical training programmes fall short regarding residents' development of generic competencies (communication, collaboration, leadership, professionalism) and reflective and deliberate practice. Paying attention to these non-technical skills in a structural manner during postgraduate training could result in a workforce better prepared for practice. A development oriented performance assessment (PA), which assists residents with assessment of performance and deliberately planned learning activities, could potentially contribute to filling this gap. This study aims to explore residents experiences with the PA.Methods: We conducted a qualitative interview study with 16 residents from four different medical specialties who participated in the PA, scheduled halfway postgraduate training. The PA was conducted by an external facilitator, a psychologist, and focused specifically on professional development and career planning. Residents were interviewed 6 months after the PA. Data were analysed using the framework method for qualitative analysis.Results: Residents found the PA to be of additional value for their training. The overarching merit was the opportunity to evaluate competencies not usually addressed in workplace-based assessments and progress conversations. In addition, the PA proved a valuable tool for assisting residents with reflecting upon their work and formulating their learning objectives and activities. Residents reported increased awareness of capacity, self-confidence and enhanced feelings of career ownership. An important factor contributing to these outcomes was the relationship of trust with the facilitator and programme director.Conclusion: The PA is a promising tool in fostering the development of generic competencies and reflective and deliberate practice. The participating residents, facilitator and programme directors were able to contribute to a safe learning environment away from the busy workplace. The facilitator plays an important role by providing credible and informative feedback. Commitment of the programme director is important for the implementation of developmental plans and learning activities. Show less
