Appreciating Appreciation: Residents' Experience Feeling Valued Differently as Learners, Physicians, and Employees.

Purpose: Cultures of wellness, defined as shared norms, values, attitudes, and behaviors that promote personal and professional growth and well-being, are robust determinants of professional fulfillment and professional performance. A major and largely overlooked aspect of a culture of wellness in medicine is residents' perceived appreciation or experience of feeling valued. Considering the pressing workforce and retention challenges that residency programs face, this study addressed the following research questions: How does appreciation at work manifest in the eyes of residents and how do residents perceive appreciation in relation to their professional fulfillment and performance?

Method: Guided by an interpretative phenomenological approach, this qualitative study purposively sampled 12 residents from different specialties, training years, regions in the Netherlands, and genders.

The experiences of students with mental health difficulties at medical school: a qualitative interview study.

Background: High rates of burnout, anxiety, and depression in medical students are widespread, yet we have limited knowledge of the medical school experiences of students with mental health issues. The aim of the study is to understand the impact of mental health issues on students' experience and training at medical school by adopting a qualitative approach.

Methods: Qualitative study using in-depth semi-structured interviews with 20 students with mental health issues from eight UK medical schools of varying size and location.

Centering Public Perceptions on Translating AI Into Clinical Practice: Patient and Public Involvement and Engagement Consultation Focus Group Study.

Background: Artificial intelligence (AI) is widely considered to be the new technical advancement capable of a large-scale modernization of health care. Considering AI's potential impact on the clinician-patient relationship, health care provision, and health care systems more widely, patients and the wider public should be a part of the development, implementation, and embedding of AI applications in health care. Failing to establish patient and public engagement and involvement (PPIE) can limit AI's impact.

Doctors' alertness, contentedness and calmness before and after night shifts: a latent profile analysis.

Background: While night shifts are crucial for patient care, they threaten doctors' well-being and performance. Knowledge of how the impact of night shifts differs for doctors is needed to attenuate the adverse effects of night shifts. This study aimed to obtain more precise insight into doctors' feelings surrounding night shift by: identifying profiles based on doctors' alertness, contentedness and calmness scores before and after night shifts (research question (RQ) 1); assessing how doctors' pre- and post-shift profiles change (RQ2); and determining associations of doctors' demographics and shift circumstances with alertness, contentedness and calmness change (RQ3).

Linking leadership development programs for physicians with organization-level outcomes: a realist review.

Background: Hospitals invest in Leadership Development Programs (LDPs) for physicians, assuming they benefit the organization's performance. Researchers have listed the advantages of LDPs, but knowledge of how and why organization-level outcomes are achieved is missing.

Objective: To investigate how, why and under which circumstances LDPs for physicians can impact organization-level outcomes.

A national longitudinal cohort study of factors contributing to UK medical students' mental ill-health symptoms.

Background: The mental health of current medical students is predictive of their mental health as future doctors. The prevalence of anxiety, depression and burnout is high among medical students, but less is known about the occurrence of other mental ill-health symptoms, such as eating or personality disorders, and factors contributing to mental ill-health.

Aims: (1) To explore the prevalence of various mental ill-health symptoms in medical students and (2) to investigate what medical school factors and students' attitudes contribute to these mental ill-health symptoms.

UK medical students' mental health during the COVID-19 pandemic: a qualitative interview study.

Objectives: To understand the impact of COVID-19 on medical students with mental health problems.

Design: Qualitative study employing in-depth semistructured interviews with medical students which were analysed using reflexive thematic analysis.

Setting And Participants: A purposive sample of 20 students originating from 8 geographically spread UK medical schools were selected, representing various mental health issues and demographic characteristics.

Structural equation modelling analysis on relationships of job demands and resources with work engagement, burnout and work ability: an observational study among physicians in Dutch hospitals.

Objective: To investigate to what extent work engagement mediates the relationships of job resources with work ability, and to what extent burnout mediates the relationships of job demands and resources with work ability.

Design: Multicentre observational study.

Setting: Academic and non-academic hospitals in the Netherlands.

Work-Related Well-Being Among Dutch Cardiologists - A National Survey.

This is the first study to provide a holistic examination of cardiologists' well-being, investigating positive and negative dimensions, and its determinants. We conducted a national, multicenter, self-administered web-based questionnaire. We used frequencies to depict scores on three well-being indicators (professional fulfillment, work exhaustion and interpersonal disengagement) and performed three multiple regression analyses to elucidate their determinants.

Exploring nurses' role in guiding residents' workplace learning: A mixed-method study.

Introduction: Understanding residents' workplace learning could be optimized by not only considering attending physicians' role but also the role of nurses. While previous studies described nurses' role during discrete activities (e.g.

Building organisations, setting minds: exploring how boards of Dutch medical specialist companies address physicians' professional performance.

Background: Governments worldwide are reforming healthcare systems to achieve high quality and safe patient care while maintaining costs. Self-employed physicians reorganise into novel organisations to meet reconfiguration demands, impacting their work environment and practice. This study explores what strategies these novel organisations use to address physicians' professional performance and what they encounter when executing these strategies to achieve high quality and safe care.

Uncovering trends in training progression for a national cohort of psychiatry trainees: discrete-time survival analysis.

Background: The global rise in mental health issues calls for a strong psychiatry workforce. Yet, psychiatry training worldwide is facing recruitment challenges, causing unfilled consultant posts and possibly threatening the quality of patient care. An in-depth understanding of trainees' progression through training is warranted to explore what happens to recruited trainees during training.

An act of performance: Exploring residents' decision-making processes to seek help.

Context: Residents are expected to ask for help when feeling insufficiently confident or competent to act in patients' best interests. While previous studies focused on the perspective of supervisor-resident relationships in residents' help-seeking decisions, attention for how the workplace environment and, more specifically, other health care team members influence these decisions is limited. Using a sociocultural lens, this study aimed to explore how residents' decision-making processes to seek help are shaped by their workplace environment.

Associations between job demands, job resources and patient-related burnout among physicians: results from a multicentre observational study.

Objectives: To investigate associations of job demands and resources with patient-related burnout among physicians.

Design: Multicentre observational study.

Setting: Fifty medical departments at 14 (academic and non-academic) hospitals in the Netherlands.

The Dutch residency educational climate test: construct and concurrent validation in Spanish language.

Objectives: To translate the 35-item version of the Dutch Residency Educational Climate Test (D-RECT), and assess its reliability, construct validity and concurrent validity in the Spanish language.

Methods: For this validation study, the D-RECT was translated using international recommendations. A total of 220 paper-based resident evaluations covering two Colombian universities were cross-sectionally collected in 2015.

Team up! Linking teamwork effectiveness of clinical teaching teams to residents' experienced learning climate.

Supportive learning climates are key to ensure high-quality residency training. Clinical teachers, collaborating as teaching team, have an important role in maintaining such climates since they are responsible for residency training. Successful residency training is dependent on effective teamwork within teaching teams.

The Relationship Between the Learning and Patient Safety Climates of Clinical Departments and Residents' Patient Safety Behaviors.

Purpose: Improving residents' patient safety behavior should be a priority in graduate medical education to ensure the safety of current and future patients. Supportive learning and patient safety climates may foster this behavior. This study examined the extent to which residents' self-reported patient safety behavior can be explained by the learning climate and patient safety climate of their clinical departments.

Hospital-wide education committees and high-quality residency training : A qualitative study.

Introduction: High-quality residency training is of utmost importance for residents to become competent medical specialists. Hospital-wide education committees have been adopted by several healthcare systems to govern postgraduate medical education and to support continuous quality improvement of residency training. To understand the functioning and potential of such committees, this study examined the mechanisms through which hospital-wide education committees strive to enable continuous quality improvement in residency training.

Towards healthy learning climates in postgraduate medical education: exploring the role of hospital-wide education committees.

Background: Postgraduate medical education prepares residents for delivery of high quality patient care during training as well as for later practice, which makes high quality residency training programs crucial to safeguard patient care. Healthy learning climates contribute to high quality postgraduate medical education. In several countries, modernization of postgraduate medical education has resulted in hospital-wide responsibilities for monitoring learning climates.

Investigating Physicians' Views on Soft Signals in the Context of Their Peers' Performance.

Background: Physicians are responsible for delivering high quality of care. In cases of underperformance, hindsight knowledge indicates forewarning being potentially available in terms of concerns, signs, or signals. It is not known how the physicians involved perceive such signals.

From good to excellent: Improving clinical departments' learning climate in residency training.

Introduction: The improvement of clinical departments' learning climate is central to achieving high-quality residency training and patient care. However, improving the learning climate can be challenging given its complexity as a multi-dimensional construct. Distinct representations of the dimensions might create different learning climate groups across departments and may require varying efforts to achieve improvement.

Focus on Quality: Investigating Residents' Learning Climate Perceptions.

Background: A department's learning climate is known to contribute to the quality of postgraduate medical education and, as such, to the quality of patient care provided by residents. However, it is unclear how the learning climate is perceived over time.

Objectives: This study investigated whether the learning climate perceptions of residents changed over time.

Revisiting the D-RECT tool: Validation of an instrument measuring residents' learning climate perceptions.

Introduction: Credible evaluation of the learning climate requires valid and reliable instruments in order to inform quality improvement activities. Since its initial validation the Dutch Residency Educational Climate Test (D-RECT) has been increasingly used to evaluate the learning climate, yet it has not been tested in its final form and on the actual level of use - the department.

Aim: Our aim was to re-investigate the internal validity and reliability of the D-RECT at the resident and department levels.