Introducing "optimal challenges" in resident training

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Background: Residents are often caught between two interests: the resident’s desire to participate in challenging learning situations and the department’s work planning. However, these interests may clash if they are not coordinated by the senior doctors, and challenging learning situations risk being subject to work planning.
Summary of work: Inspired by Csikszentmihalyi’s concept of optimal challenges, an intervention study aimed at introducing a more suitable planning of residents' learning in terms of optimal allocation of educational patient contacts. The objective was to coordinating residents’ individual competences and learning needs with patient characteristics in order to match each resident with a case (an outpatient or a patient) that meets the learning needs of the resident and thus pose an optimal challenge to the resident.
Summary of results: The preliminary results show that the residents benefit from the intervention because they experienced more optimal challenges than before the intervention. However, the matching of resident and case seems to work against the established culture in the department: The daily work has for many years been organized so that senior doctors have their “own” patients and they do not “share” patients with residents. Thus the patients were accustomed to have their “own” specialist doctor.
Conclusion: The intervention generated optimal challenges, but revealed the need for more team-based organization of senior doctors and residents’ working relationships in order to meet the health system’s and the patients’ call for continuity in the treatment.
Take-home message: The matching of resident and case stimulates optimal learning situations, but cultural and organizational values concerning the doctor-patient continuity are challenged.
Original languageEnglish
Publication year2014
Publication statusPublished - 2014
EventAssociation for Medical Education in Europe 2014: Excellence in Education. The 21st Century Teacher. - MiCo Milano Congressi, Milano, Italy
Duration: 30 Aug 20143 Sep 2014


ConferenceAssociation for Medical Education in Europe 2014
LocationMiCo Milano Congressi

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