Characteristics of residency programs and residents’ learning experience in Brazil: a multispecialty, nation-wide study

ABSTRACT

Factors associated with the optimal physician resident learning are yet to be fully understood. We aimed to correlate the characteristics of residency programs with the learning perception of residents. This was a cross-sectional study using an online structured questionnaire published on social networks, enrolling physician residents from almost all specialties in Brazil. The collection tool was settled considering the current national standards of medical residency programs in Brazil and it was internally validated. The response rate was 71.4% (n = 1,419). The median age was 28 years (IQR = 27–30), 51.9% were from clinical areas and 69.9% from the first or second postgraduation year. Adequate quality of faculty supervision was reported by 50.9%; frequent supervision of assistance activities in 22.1%; proper structure for carrying out healthcare in 82.1%, formal appraisals in 81.8%, classroom activities more than three times a week in 12.3%. Learning was rated as satisfactory by 70.8%. We found an ‘inverted-U’ shape correlation between duty hours and learning – briefer and longer workloads were associated with unsatisfactory learning. The factors independently associated with learning satisfaction were quantity (OR = 10.79, 95%CI = 7.38–15.77) and quality (1.68, 1.19–2.37) of preceptorship, structure for healthcare (2.10, 1.44–3.08), formal evaluations (1.83, 1.26–2.67), and briefer workload (0.18, 0.04–0.90) and age (0.94, 0.89–0.99) (AUROC = 0.838, 95%CI = 0.816–0.860). We conclude that the perception of satisfactory learning was influenced by higher frequency and quality of faculty supervision, adequate structure for healthcare, formal assessments, and reduced duty hours and age. Regulatory institutions should reinforce strategies to guarantee the fulfillment of residency standards and faculties should receive continued formal training to maximize their teaching skills.

KEYWORDS:

• Learning
• medical residency
• medical education
• workload
• preceptorship
• learning curve
• healthcare quality

Abbreviations

PHQ-4:Patient Health Questionnaire-4; PGY:postgraduate year

Data availability statement

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics approval

Ethical approval for this study was obtained from the Federal University of Pernambuco Ethics Committee (approval number: 3.314.833). We confirm that all methods were carried out in accordance with the Brazilian Ethics standards.

Consent to participate

All participants gave their written informed consent prior to enroll in the survey.

Author contributions

MLM: concepted and designed the study, acquired data, performed statistical analysis and wrote the draft of the study. PSA and MMV: designed the study and reviewed critically and scientifically the paper.

Geolocation information

Data were collected from individuals from all federational units of Brazil.

Additional information

Funding

This study did not receive any grants or funding.