Program directors strategies to foster (organizational) socialization of newcomer residents in PGME

ABSTRACT:
Background: In Postgraduate Medical Education (PGME), newcomer residents experience the transition to their new role as demanding. Part of Program Directors (PD) role is to facilitate this transition. However, they tend to focus on organizing / structuring the curriculum rather than supporting residents in their
organizational socialization process, an important topic that has received little attention. To deepen our understanding and develop strategies to foster residents socialization, we investigated PDs perceptions of how they support residents socialization. Summary of Work: We conducted a multi-site, qualitative study with semi-structured interviews. An inductive-deductive approach was employed. In an iterative process, we inductively analyzed the data by
thematic analysis and deductively interpreted the data through the theoretical lens of OS. The latter was based on the six organizational socialization tactics of van Maanen & Schein (1). A key characteristic of these tactics is the description of how others in the organization facilitate socialization processes for
newcomer individuals in transition from one role to another.
Summary of Results: We inductively discovered that some PDs supported socialization explicit, other PDs were more implicit in their approach. This is illustrated alongside the six organizational tactics; collectiveindividual,
formal-informal, sequential-random, fixed-variable, serial-disjunctive and investiture-divestiture. (I) PDs implicitly valued peer group processes and used explicitly individual tactics when residents failed or underperformed. (II) One PD explicitized socialization in the introduction program, but often socialization
was not considered a learning objective. (III) Some PDs explicitly sequenced the socialization process, but in other situations collaboration had not been arranged. (IV) The fixed and variable tactic could not be divided in explicit and implicit support. (V) Role modelling influenced residents socialization. PDs
awareness and explicit use of role modelling varied. The disjunctive tactic (absence role modelling) was not identified. (VI) Some PDs accepted newcomer residents as who they were, but others expected residents to conform to their (implicit) expectations. Discussion and Conclusions: PDs support to promote residents organizational socialization was often implicit, occurred more by default than by design and lacked structure. However, some PDs structured and
formalized their support. Take-home Messages: The challenge for PDs, faculty and residents is to establish socialization as learning objective for all newcomer residents in transition.