title: Attending doctors' perspectives on how residents learn.
abstract: BACKGROUND
  Graduate medical education is currently facing major educational reforms. There is a lack of empirical evidence in the literature about the learning processes of residents in the clinical workplace. This qualitative study uses a 'grounded theory' approach to continue the development of a theoretical framework of learning in the clinical workplace by adding the perspective of attending doctors.
  
  
  METHODS
  A total of 21 Dutch attending doctors involved in the training of residents in obstetrics and gynaecology participated in 1 of 3 focus group sessions. They discussed their perceptions of how residents learn and what factors influence residents' learning. A grounded theory approach was used to analyse the transcribed discussions.
  
  
  RESULTS
  Three related themes emerged. The first concerned the central role of participation in work-related activities: according to attending doctors, residents learn by tackling the everyday challenges of clinical work. The second involved the ways in which attending doctors influence what residents learn from work-related activities. The final theme focused on attending doctors' views of the essential characteristics of residents and their development during residency.
  
  
  CONCLUSIONS
  Attending doctors' perspectives complement current insights derived from similar research among residents and from related literature. As part of an ongoing effort to further develop understanding of how residents learn, this study adds several ways in which attending doctors strive to combine guidance in both patient care and resident training. Furthermore, attending doctors' perspectives draw attention to other aspects of learning in the clinical workplace, such as the role of confidence and the balance between supervision and independence.
authors.affiliation: Institute for Medical Education, VU University Medical Center, Amsterdam, The Netherlands. pwteunissen@gmail.com
authors.forename: P W
authors.initials: PW
authors.lastname: Teunissen
authors.forename: K
authors.initials: K
authors.lastname: Boor
authors.forename: A J J A
authors.initials: AJ
authors.lastname: Scherpbier
authors.forename: C P M
authors.initials: CP
authors.lastname: van der Vleuten
authors.forename: J A A M
authors.initials: JA
authors.lastname: van Diemen-Steenvoorde
authors.forename: S J
authors.initials: SJ
authors.lastname: van Luijk
authors.forename: F
authors.initials: F
authors.lastname: Scheele
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards; D003479:Curriculum; D017144:Focus Groups; D006176:Gynecology / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D007858:Learning; D008875:Middle Aged; D009426:Netherlands