How do programme directors perceive trainee attrition? A qualitative focus group study in three Dutch teaching hospitals
Objective To gain insight into programme directors’ (PDs’) perceptions of trainee attrition from postgraduate medical education (PGME), focusing on interactions between stakeholders within the learning environment and roles of PDs in the process leading to attrition.Design, setting and participants...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2025-06-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/6/e088316.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850233700754653184 |
|---|---|
| author | Jacqueline Bustraan Kirsten Dijkhuizen Erik Driessen Jan M M van Lith Arnout Jan de Beaufort Maartje E D van den Bogaard |
| author_facet | Jacqueline Bustraan Kirsten Dijkhuizen Erik Driessen Jan M M van Lith Arnout Jan de Beaufort Maartje E D van den Bogaard |
| author_sort | Jacqueline Bustraan |
| collection | DOAJ |
| description | Objective To gain insight into programme directors’ (PDs’) perceptions of trainee attrition from postgraduate medical education (PGME), focusing on interactions between stakeholders within the learning environment and roles of PDs in the process leading to attrition.Design, setting and participants We performed a focus group study with 27 PDs from three Dutch teaching hospitals and analysed transcripts using template analysis.Results PDs identified attrition as a multilevel problem, in which personal, workplace and system-bound factors play a role. PDs mentioned balancing professional and personal responsibilities, in particular parenthood and high ambitions, as important trainee-related factors. PDs adopt different, at times conflicting, roles when guiding trainees, for example, assessor and mentor, and they struggle to balance these roles. They displayed various emotions when discussing attrition, varying from disappointment to frustration and anger, yet could also frame attrition positively as new opportunity. PDs used numerous resources to support trainees in difficulty, in a reactive rather than in a pro-active manner. A generation difference between faculty and trainees regarding work-life balance was mentioned as impeding mutual understanding. On the system level, PDs observed how implicit beliefs and negative interactions between actors in the learning environment impede trainees’ well-being.Conclusions PDs perceived trainee attrition as a multi-level problem that highlighted conflicting roles for the PD and evoked a wide range of emotions. The authors propose the following interventions: (1) address conflicting roles of PDs by reallocating specific tasks to other independent ‘third parties’, for example, professional coaching; (2) implement pro-active support for trainees unrelated to assessment; (3) create awareness of implicit assumptions of stakeholders and promote social belonging; (4) foster a supportive learning climate with clinical leaders as role models. |
| format | Article |
| id | doaj-art-ee629ed7b48b4ee5a17e96276f3a68f8 |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-ee629ed7b48b4ee5a17e96276f3a68f82025-08-20T02:02:51ZengBMJ Publishing GroupBMJ Open2044-60552025-06-0115610.1136/bmjopen-2024-088316How do programme directors perceive trainee attrition? A qualitative focus group study in three Dutch teaching hospitalsJacqueline Bustraan0Kirsten Dijkhuizen1Erik Driessen2Jan M M van Lith3Arnout Jan de Beaufort4Maartje E D van den Bogaard5Center for Innovation in Medical Education, Leiden University Medical Center, Leiden, The NetherlandsCenter for Innovation in Medical Education, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Educational Development and Research, Maastricht University, Maastricht, The NetherlandsDepartment of Obstetrics, Leiden University Medical Center, Leiden, The NetherlandsCenter for Innovation in Medical Education, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Engineering Education Research, University of Michigan, Ann Arbor, Michigan, USAObjective To gain insight into programme directors’ (PDs’) perceptions of trainee attrition from postgraduate medical education (PGME), focusing on interactions between stakeholders within the learning environment and roles of PDs in the process leading to attrition.Design, setting and participants We performed a focus group study with 27 PDs from three Dutch teaching hospitals and analysed transcripts using template analysis.Results PDs identified attrition as a multilevel problem, in which personal, workplace and system-bound factors play a role. PDs mentioned balancing professional and personal responsibilities, in particular parenthood and high ambitions, as important trainee-related factors. PDs adopt different, at times conflicting, roles when guiding trainees, for example, assessor and mentor, and they struggle to balance these roles. They displayed various emotions when discussing attrition, varying from disappointment to frustration and anger, yet could also frame attrition positively as new opportunity. PDs used numerous resources to support trainees in difficulty, in a reactive rather than in a pro-active manner. A generation difference between faculty and trainees regarding work-life balance was mentioned as impeding mutual understanding. On the system level, PDs observed how implicit beliefs and negative interactions between actors in the learning environment impede trainees’ well-being.Conclusions PDs perceived trainee attrition as a multi-level problem that highlighted conflicting roles for the PD and evoked a wide range of emotions. The authors propose the following interventions: (1) address conflicting roles of PDs by reallocating specific tasks to other independent ‘third parties’, for example, professional coaching; (2) implement pro-active support for trainees unrelated to assessment; (3) create awareness of implicit assumptions of stakeholders and promote social belonging; (4) foster a supportive learning climate with clinical leaders as role models.https://bmjopen.bmj.com/content/15/6/e088316.full |
| spellingShingle | Jacqueline Bustraan Kirsten Dijkhuizen Erik Driessen Jan M M van Lith Arnout Jan de Beaufort Maartje E D van den Bogaard How do programme directors perceive trainee attrition? A qualitative focus group study in three Dutch teaching hospitals BMJ Open |
| title | How do programme directors perceive trainee attrition? A qualitative focus group study in three Dutch teaching hospitals |
| title_full | How do programme directors perceive trainee attrition? A qualitative focus group study in three Dutch teaching hospitals |
| title_fullStr | How do programme directors perceive trainee attrition? A qualitative focus group study in three Dutch teaching hospitals |
| title_full_unstemmed | How do programme directors perceive trainee attrition? A qualitative focus group study in three Dutch teaching hospitals |
| title_short | How do programme directors perceive trainee attrition? A qualitative focus group study in three Dutch teaching hospitals |
| title_sort | how do programme directors perceive trainee attrition a qualitative focus group study in three dutch teaching hospitals |
| url | https://bmjopen.bmj.com/content/15/6/e088316.full |
| work_keys_str_mv | AT jacquelinebustraan howdoprogrammedirectorsperceivetraineeattritionaqualitativefocusgroupstudyinthreedutchteachinghospitals AT kirstendijkhuizen howdoprogrammedirectorsperceivetraineeattritionaqualitativefocusgroupstudyinthreedutchteachinghospitals AT erikdriessen howdoprogrammedirectorsperceivetraineeattritionaqualitativefocusgroupstudyinthreedutchteachinghospitals AT janmmvanlith howdoprogrammedirectorsperceivetraineeattritionaqualitativefocusgroupstudyinthreedutchteachinghospitals AT arnoutjandebeaufort howdoprogrammedirectorsperceivetraineeattritionaqualitativefocusgroupstudyinthreedutchteachinghospitals AT maartjeedvandenbogaard howdoprogrammedirectorsperceivetraineeattritionaqualitativefocusgroupstudyinthreedutchteachinghospitals |