A Resident Training Program Focused on Interpersonal Skills and Related Themes

This seventh chapter builds forth on Chapters 5 (preparatory interviews with preceptors for designing the training programs for preceptors and residents) and 6 (training program for preceptors) and presents a second program that was developed in the project that constitutes the core of this book: a resident training program focused on interpersonal skills and related themes. In line with the stone-in-the-lake metaphor introduced in Chapter 1 , the rationale behind this program has been that empowering residents through the development of knowledge, skills, and attitudes that help them to develop and maintain good relations with others will benefit their relations with their colleagues, preceptors as well as with their patients and caregivers. As argued in Chapter 1 , healthcare teams with better relations are better equipped to facilitate job satisfaction, clinical competence, and patient satisfaction, as well as to reduce the risk of burnout of professionals and increase confidence on the part of patients and their caregivers to share all information needed for good person-centered care. This chapter reports on the development and implementation of the resident program and how it has been contributing to relations with their colleagues, preceptors as well as with their patients and caregivers. A group of 8 residents from different specialties at Marqués de Valdecilla University Hospital was followed during 16 months with six blocks of weekly questionnaires (one questionnaire per week, six weeks per block) spaced around three training periods of two days in a specific week each. The questionnaire was the same throughout the period and combined series of Likert-type items and an open-ended question regarding the perceived relation with their patients (or caregivers). Simultaneously, some of their colleagues and patients (or caregivers)—who did not know about the resident training program—responded on a weekly basis to a similar questionnaire aimed at their relations with the resident in question. Finally, at the beginning and towards the end of the 16-month period, preceptors of the residents were contacted with similar questions regarding the relation with the resident in question. The narrative data resulting from the open-ended questions was subjected to a multi-stage multi-coder procedure, which resulted in a range of qualitative examples relating to the content of the program and possible effects on the different types of stakeholders studied as well as metrics along with the rating data which were subjected to both group-level analysis (i.e., multilevel analysis) and individual analysis. Briefly put, no effects of training were found at the group level for residents, colleagues or preceptors, although for some individual residents a positive effect was found either in self-reports or in reports from patients or a colleague. At the level of patients (and caregivers), a positive effect of training was found, with more training modules predicting better performance by the resident in terms of program content-related behaviors that are known to contribute to better relations. Finally, several residents reported changes in the context—sometimes favorable, sometimes not so favorable—at some point during the study, unrelated to the training program. There is some evidence that these differences in context can facilitate (favorable context change) or hinder (not so favorable context change) the display of program content-related behaviors that are known to contribute to better relations. Implications of these findings and limitations are discussed at the end of this chapter and in more detail in Chapter 9 .