Journal of Medical Education and Curricular Development (10/19/23) Dayan, Riki; Quach, Tien T.T.; With, Sheila; et al.

Researchers present a case study involving academic half days (AHDs) in a large obstetrics and gynecology residency training program over five years, exploring residents' perceived reasons for AHDs, effective AHD components and underlying sustainability factors. Interviews with focus groups of residents in 2013 and 2018 spanned the program's evolution from a once-weekly resident-led didactic session with supporting faculty to a faculty-led didactic session. Most AHDs occurred in a classroom setting, although other activities throughout the year included simulations, pig lab, wellness days, objective structured clinical exams and practice board exams. The researchers extracted 10 themes from resident focus group data surrounding the three overarching questions. Analysis indicated the perceived purpose of AHDs is to acquire knowledge and structure as well as evidence to facilitate clinical reasoning for junior residents and to prepare senior residents for an advanced exam. Residents also cited gaining peer support, mentorship and communities of practice as an important secondary purpose. Participants identified effective AHD elements as formative evaluation and active participation, equilibrium between resident presentations and faculty input and protection from clinical duties. The AHD sustainability factors they identified included the elimination of scheduling barriers, administrative support for scheduling and logistics and the value of feedback for improvement. The researchers suggest threshold concepts as a future pathway for exploring classroom-based residency learning. "One of the recurring themes in this study is that there are certain concepts which represent 'troublesome knowledge,' and having faculty input and near-peer teaching in the classroom setting may be helpful for this," they note.

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