Patient safety in medical residency training: Balancing bravery and checklists

Guusje Bressers*, Iris Wallenburg, Renee Stalmeijer, Mirjam Oude Egbrink, Kiki Lombarts

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Distributing responsibility for patient safety between individual professionals and organisational systems is a pressing issue in contemporary healthcare. This article draws on Habermas' distinction between 'lifeworld' and 'system' to explore patient-safety culture in medical residency training. Sociological accounts of medical training have indicated that applying systemic solutions in patient-safety training and practice may conflict with residents' needs. Residents would navigate safety systems to get their work done and safeguard learning opportunities, acting 'in between' the system and traditional processes of socialisation and learning on the job. Our ethnographic study reveals how residents seek to connect system and professional-based learning, and do them together in situated manners that evolve in the course of medical training. We reveal three themes that closely align with the residents' developmental process of maturing during training and on the job to become 'real' physicians: (1) coming to grips with the job; (2) working around safety procedures; and (3) moving on to independence. A more explicit focus on learning to deal with uncertainty may enable residents to become more skilled in balancing safety systems.

Original languageEnglish
Pages (from-to)494-512
Number of pages19
JournalHealth: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine
Volume25
Issue number4
Early online date21 Jan 2020
DOIs
Publication statusPublished - Jul 2021

Keywords

  • anaesthesiology
  • emergency medicine
  • ethnography
  • hospital
  • lifeworld
  • medical residency training
  • patient safety
  • patient-safety culture
  • system
  • The Netherlands
  • EDUCATION
  • COMMUNICATION
  • TRANSITION
  • WORK

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