Qualitative Study of the Learning Process of Resident Physicians in China

Background: In clinical education, the resident learning environment has shifted from classrooms to hospitals, where residents must engage with patients and cultivate the ability to care for and treat patients. Residents transitioning to this new work environment face new challenges and establish new learning methods. Methods: To explore the challenges, learning methods, and response strategies that Chinese residents face as they interact with various environmental factors during the learning process. The participants were interviewed in depth. The interview outline covered four major themes: clinical learning experience and reflection on learning, experience interacting with patients, experience working with other medical staff, and future learning direction. 29 residents participated in the study. Findings: In the early stage of clinical education, residents are challenged by patients’ distrust in them due to their identity, medical skills, and communication skills. Residents have a higher level of motivation to learn clinical-related contents. Residents learn more effectively when their teachers have excellent teaching skills and the use of a balanced direction. A balanced direction indicates that teachers allow students to gain hands-on experience in clinical operations and provide them with assistance and guidance when required. Residents learn from not only senior physicians but also other health professionals in the work environment. Formal curriculum guides resident learning, and other events that occur during residency training, such as clinical skills competition, also improve resident learning performance. In residency training, residents experience burnout because of heavy workload and poor doctor–patient relations, with some residents even opting for a career change after their residency training. Interpretation: Residents’ learning performance is not based solely on the curriculum but also on the interactive effects of different elements related to them and their learning environment, such as patients, physicians, other health professionals, the workplace, and residents’ perception of self-identity. Funding Statement: This study was funded by the Higher Education Reform Project of Guangdong Province, China (Project No. 2017465). Declaration of Interests: The authors declare that there are no conflicts of interest. Ethics Approval Statement: This study was reviewed and approved by the Institutional Review Board of Qingyuan People’s Hospital in Guangdong, China (IRB: QPH-IRB-A0141).