Optimizing learning environments and resident well-being in postgraduate medical education

Well-educated and mentally fit physicians are conditional for good patient care. Postgraduate medical educational programs have been modernized: they have become competency-based. An important condition for a successful educational program is an optimal learning environment. Besides, an optimal learning environment is thought to stimulate the mental well-being of physicians in training to become a medical specialist (residents).

This thesis aims to evaluate the introduction of competency-based medical education (CBME), the impact of this introduction on the learning environment and the role the learning environment plays in determining resident well-being.

We found that residents appreciated the introduction of several core components of CBME, namely: the more explicit assessment, enhanced supervisory support and a portfolio as a tool for coaching and reflection.

Furthermore, we found that the learning environment plays a key role in determining resident well-being: an optimal learning environment reduces the risk of resident burnout and stimulates resident engagement. Important aspects of the learning environment in determining resident well-being are: sufficient learning opportunities, autonomy, receiving constructive feedback and a so-called culture of growth. Supervisors should be aware of their crucial role in fostering resident well-being. Finally, we found that the first wave of the COVID-19 pandemic did not have a negative short-term impact on the well-being of residents involved in COVID-19 care.

We concluded by stating that the ultimate goal of modernizing postgraduate medical education and creating a supportive learning environment that promotes resident well-being, is the ongoing improvement of patient care.