Learning by internal medicine residents

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Abstract
OBJECTIVE: To learn about what enhances or hinders learning in postgraduate medical education. DESIGN AND PARTICIPANTS: Through the use of critical incident interviews, 20 internal medicine residents and 20 attending physicians/faculty were asked to describe specific situations where resident learning had occurred and where it had not occurred. SETTING: A large teaching hospital in the Midwest. MEASUREMENTS AND MAIN RESULTS: Factors positively associated with learning were mentioned frequently (faculty involvement, interaction, and reflection in discussion), and others only rarely (knowing outcomes of effort, resident reading) by both the faculty and the residents. Others were mentioned more often by the residents (feeling relaxed) or by the faculty (technical rationality)! CONCLUSIONS: Residents and attendings do not always agree as to what facilitates resident learning. Recognizing actions that residents believe facilitate learning may help faculty more effectively promote resident learning. Because of the similarities of resident training across the country, the results from this study can be applied to other programs.

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