Resident assessment facilitation team: collaborative support for activated learning

Because healthcare knowledge, practices and systems change so rapidly, physicians-in-training need to develop skills related to lifelong learning. The adult learning paradigm defines the effective professional learner as autonomous and activated. A part of the residency’s p4 (Preparing the Personal Physician for Practice) redesign, the RAFT (Resident Assessment Facilitation Team) process was designed to encourage residents’ adoption of activated learning behaviors by incorporating their participation in team-based educational planning and assessment of competence. This study examined interaction within the RAFT meetings to guage residents’ adoption of activated learning behaviors over time. In this study, transcripts of RAFT meetings from a single cohort of residents during the first and third years of training were analyzed using a grounded theory approach. Teams of at least two analysts per transcript engaged in two rounds of descriptive coding and three levels of axial coding to examine interaction during the RAFT meetings and identify how that interaction was related to residents’ activated learning. Four categories of interaction were identified: advising, managing the process of the meeting, expressing and managing emotion, and demonstrating reflective practice and mindfulness. Across those categories, 36 sub-types of messages indicated both similarities and differences between first- and third-year residents. Specifically, third-year residents took a more active leadership role in meetings; faculty team members were more likely to hand over responsibility for problem solving to thirdyear residents. Integrating residents into the RAFT advising and assessment process provides a context for residents to practice and exhibit activated learning behaviors.