TY - JOUR
T1 - Incorporating value-based healthcare projects in residency training
T2 - a mixed-methods study on the impact of participation on understanding and competency development
AU - Vaassen, Sanne
AU - Essers, Brigitte A B
AU - Stammen, Lorette A
AU - Walsh, Kieran
AU - Kerssens, Marlou
AU - Evers, Silvia M A A
AU - Heyligers, Ide
AU - Stassen, Laurents P S
AU - van Mook, Walther N K A
AU - Noben, Cindy Y G
N1 - © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2022/8/17
Y1 - 2022/8/17
N2 - OBJECTIVES: Stimulating the active participation of residents in projects with societally relevant healthcare themes, such as value-based healthcare (VBHC), can be a strategy to enhance competency development. Canadian Medical Education Directions for Specialists (CanMEDS) competencies such as leader and scholar are important skills for all doctors. In this study, we hypothesise that when residents conduct a VBHC project, CanMEDS competencies are developed. There is the added value of gaining knowledge about VBHC.DESIGN: An explorative mixed-methods study assessing residents' self-perceived learning effects of conducting VBHC projects according to three main components: (1) CanMEDS competency development, (2) recognition of VBHC dilemmas in clinical practice, and (3) potential facilitators for and barriers to implementing a VBHC project. We triangulated data resulting from qualitative analyses of: (a) text-based summaries of VBHC projects by residents and (b) semistructured interviews with residents who conducted these projects.SETTING: Academic and non-academic hospitals in the Netherlands.PARTICIPANTS: Out of 63 text-based summaries from residents, 56 were selected; and out of 19 eligible residents, 11 were selected for semistructured interviews and were included in the final analysis.RESULTS: Regarding CanMEDS competency development, the competencies 'leader', 'communicator' and 'collaborator' scored the highest. Opportunities to recognise VBHC dilemmas in practice were mainly stimulated by analysing healthcare practices from different perspectives, and by learning how to define costs and relate them to outcomes. Finally, implementation of VBHC projects is facilitated by a thorough investigation of a VBHC dilemma combined with an in-depth stakeholder analysis.CONCLUSION: In medical residency training programmes, competency development through active participation in projects with societally relevant healthcare themes-such as VBHC-was found to be a promising strategy. From a resident's perspective, combining a thorough investigation of the VBHC dilemma with an in-depth stakeholder analysis is key to the successful implementation of a VBHC project.
AB - OBJECTIVES: Stimulating the active participation of residents in projects with societally relevant healthcare themes, such as value-based healthcare (VBHC), can be a strategy to enhance competency development. Canadian Medical Education Directions for Specialists (CanMEDS) competencies such as leader and scholar are important skills for all doctors. In this study, we hypothesise that when residents conduct a VBHC project, CanMEDS competencies are developed. There is the added value of gaining knowledge about VBHC.DESIGN: An explorative mixed-methods study assessing residents' self-perceived learning effects of conducting VBHC projects according to three main components: (1) CanMEDS competency development, (2) recognition of VBHC dilemmas in clinical practice, and (3) potential facilitators for and barriers to implementing a VBHC project. We triangulated data resulting from qualitative analyses of: (a) text-based summaries of VBHC projects by residents and (b) semistructured interviews with residents who conducted these projects.SETTING: Academic and non-academic hospitals in the Netherlands.PARTICIPANTS: Out of 63 text-based summaries from residents, 56 were selected; and out of 19 eligible residents, 11 were selected for semistructured interviews and were included in the final analysis.RESULTS: Regarding CanMEDS competency development, the competencies 'leader', 'communicator' and 'collaborator' scored the highest. Opportunities to recognise VBHC dilemmas in practice were mainly stimulated by analysing healthcare practices from different perspectives, and by learning how to define costs and relate them to outcomes. Finally, implementation of VBHC projects is facilitated by a thorough investigation of a VBHC dilemma combined with an in-depth stakeholder analysis.CONCLUSION: In medical residency training programmes, competency development through active participation in projects with societally relevant healthcare themes-such as VBHC-was found to be a promising strategy. From a resident's perspective, combining a thorough investigation of the VBHC dilemma with an in-depth stakeholder analysis is key to the successful implementation of a VBHC project.
KW - Canada
KW - Clinical Competence
KW - Delivery of Health Care
KW - Humans
KW - Internship and Residency
KW - Physicians
U2 - 10.1136/bmjopen-2021-060682
DO - 10.1136/bmjopen-2021-060682
M3 - Article
C2 - 35977765
SN - 2044-6055
VL - 12
JO - BMJ Open
JF - BMJ Open
IS - 8
M1 - e060682
ER -