Interactions that matter: Understanding residents' professional growth through workplace relationships

At the heart of learning within the clinical workplace is learning through interactions. Based on this sociocultural perspective, I explored in this dissertation how residents’ interactions with supervisors, nurses, and patients shape their learning and clinical practice.
To this end, I conducted four studies, each focusing on one or more workplace interactions. I first focused on how residents navigate various workplace interactions by examining how they seek help during their training (Chapter 2). Then, I explored resident-patient interactions to understand residents’ and patients’ perceptions of compassionate care (Chapter 3). Next, I delved into the interactions between residents and nurses by examining how both residents and nurses perceive the guiding role of nurses within residents’ workplace learning (Chapter 4). Finally, in Chapter 5, I focused on residents’ interactions with supervisors; specifically, I looked at the effectiveness of teams of supervisors collaborating within teaching teams and whether this teamwork is associated with how residents perceived their learning climate.
In this dissertation, I demonstrate that, through residents’ interactions with supervisors, nurses, and patients, they developed the necessary skills and knowledge and gradually came to think, act and feel like a physician. However, learning did not automatically result from interacting with other healthcare professionals. Rather, whether and what residents learned depended on a complex and dynamic interplay of residents’ agency, the opportunities provided by workplace actors, and influencing forces within the learning environment (e.g., the culture at the workplace). To optimize residents’ workplace learning and ultimately patient care, a better understanding of these interactions is critical.