Use both qualitative and quantitative research designs, including longitudinal follow-up, to clarify which aspects of residency training best prepare doctors¶

Strategy · All strategies
Evidence · 6 claims (5 for, 1 mixed) · 1 study (1 review), q2 · 0 of 1 report an effect size · 6 claims rest on one study

Description¶

The review's research agenda calls for diversifying the evidence base on residency training and patient outcomes. It states that "both qualitative and quantitative research designs are needed to clarify which aspects of residency training best prepare doctors to deliver a high quality of care." It further recommends research on the training background of practicing physicians and prospective longitudinal follow-up of residents after finishing their residencies, noting that multicenter longitudinal databases exist but lack patient outcomes for individual doctors.

Design Implications¶

Context¶

Requirements¶

• Collaboration between researchers and clinicians and diversification of research perspectives to enrich clinical, health services and medical education research fields

Constraints¶

• Investigating causal factors that explain the relationship between residency training and patient outcomes is described as difficult

Target Learners¶

• medical education researchers
• health care services researchers
• residency program evaluators

Target Learning Goals¶

• evaluating the effect of residency training on patient outcomes during and after training
• identifying causal factors linking training aspects to care quality

Claims¶

• Individual progression of residents had a positive effect on patient outcomes, reported in seven studies [+W]
• The start of the academic year is not without risk for patient outcomes, with five of 19 studies reporting negative findings around July [+W]
• Residents' care resulted mostly in similar patient outcomes compared with faculty when dedicated supervision and additional operation time were arranged [~W]
• Progression through residency training had a positive effect on patient outcomes, with more senior residents showing better outcomes in six of ten studies [+W]
• Only one study linked physicians' prior training site to later patient outcomes, ranking programs by graduates' complication rates [+W]
• After new, modified or improved training programs, patient outcomes remained unchanged or improved in 16 of 17 studies [+W]

Related Strategies¶

• Prioritize longitudinal, comparative-effectiveness, and patient-outcome research and standardized practices for podiatry simulation
• Rigorously compare PBL with traditional methods before broad PGME implementation, using larger samples, controls, and follow-up
• Integrate quantitative and qualitative approaches in future cardiac arrest simulation feedback research

Examples¶

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Key Sources¶

• van der Leeuw Renée M, Lombarts Kiki MJMH, Arah Onyebuchi A, Heineman Maas Jan. (2012). A systematic review of the effects of residency training on patient outcomes. BMC Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3391170/