Matthew Hirschfeld
University of Rochester
Background: “Confessions” is a program leadership-moderated explicit learning activity in which residents discuss anonymously submitted confessions. Confessions allows a safe space for resident feedback, permits an opening for discussions on Professional Identity Formation (PIF), and the opportunity for identification with a Community of Practice (CoP).
Objective: This retrospective qualitative study analyzed typed confessions from Clinical Base Year residents to identify themes impacting resident PIF and participation within a CoP. We also investigated confessions from senior anesthesiology residents and from piloted interdisciplinary Confessions for progression of these themes throughout residency training.
Methods: We analyzed 244 confessions collected during 21 Confessions conducted between October, 2016 and anuary, 2020 at a single institution.
In keeping with Grounded Theory and the Constant Comparative Method, confessions were qualitatively coded in three stages: open, axial, and selective. Researcher triangulation, a code book, and member checking were used to enhance the study’s trustworthiness. The concepts of PIF and CoP served as the theoretical perspective for the study.
Results: Interrelated, longitudinal themes associated with PIF and CoP, such as “support” and “knowledge,” were uncovered. Longitudinal themes were related to important transitions during residency training and evolved over time. Episodic themes were related to local concerns.
Conclusions: Transition periods are important milestones in physician PIF and identification within a CoP. The graduate medical community should continue to focus efforts to allow residents time for studying and self- care during normal clinical hours, as well as on teaming with non- physician healthcare workers. Confessions is an easily adaptable activity for other programs and institutions.
